3520-29 Correction Form

EPA Form 3520-29

OMB Control No. 2060-0545; approval expiration date: 7/31/2010

U.S. Environmental Protection Agency
Motor Vehicle and Engine Compliance Program
Correction Form
Date:
Manufacturer Name:
Engine Family Name:
Original Payment Date:
Original Amount Paid:

$

Revised Engine Family Name:
Company Representative:
Name:

Phone:

Email Address:

Fax:

(optional)

Reason for Correction:
Typographical error in original engine family or test group name.
Overpayment for original family name, please apply the overpayment to the revised engine family name. Write
the overpayment amount in the comments box.
Other (explain in comments box):
Comments:

Submission:
(1) Forms may be filled out and submitted online at www.Pay.gov.
(2) Forms may be submitted as email attachments to [email protected]
(3) Forms may be submitted by surface mail to:
Environmental Protection Agency- NVFEL
Fees Team
Compliance and Innovative Strategies Division
2000 Traverwood
Ann Arbor, Michigan 48105
The public reporting and recordkeeping burden for this collection of information is estimated to average 18 minutes per response. Send
comments on EPA's need for this information, the accuracy of the provided burden estimate, and any suggested methods for minimizing
respondent burden, including through the use of automated collection techniques, to the Director, Collection Strategies Division, U.S.
Page
2
Environmental
Protection Agency (2822T), 1200 Pennsylvania Ave., N.W., Washington, D.C. 20460. Include the OMB control number in any
correspondence. Do not send the completed Form 3520-29 to thisInstructions
address.

EPA Form 3520-29

OMB Control No. 2060-0545; approval expiration date: 7/31/2010

This form is used to make typographical and other corrections to an engine family or test group name, to apply an overpayment on one
engine family to certification fee payment for a different engine family, and to make other changes to previously submitted fee filing
forms. For corrections requiring additional payment, use the MVECP Miscellaneous Payments Due Form, to both make the change
and submit the payment. For corrections qualifying for a refund, the refund can be treated as an overpayment using this form and
applied to another engine family, or a Refund Request Form can be used instead. All corrections are subject to EPA approval. All
forms can be found and submitted at www.Pay.gov or downloaded at www.epa.gov/otaq/fees.htm.
Manufacturer Name:
Please enter the name of the company or manufacturer.
Engine Family Name:
Enter the original test group or engine family name. If you are using the form to apply overpayments (credit balance) on more than
one engine family to the "revised" engine family name below, list the additional engine families in the comment box.
Original Payment Date:
Enter the date of the online credit card or ACH payment, or the date of the offline check, wire, or ACH payment for the original test
group or engine family. Use the best information available.
Original Amount Paid:
Indicate the amount you paid for this engine family or test group when the initial fee payment was made, if applicable.
Revised Engine Family Name:
Indicate the revised or new engine family name or test group name. If you are using the form to correct a typographical or other
mistake in the name, enter the corrected name. If you are using the form to assign a name to a previous placeholder name, enter the
assigned name. If you are using the form to apply an overpayment to a new engine family, put down the new engine family to which
the overpayment should be applied. Use one correction form for each new engine family to which overpayments are being assigned.
Company Representative:
Enter the authorized company representative information, including a contact name, email address, telephone number, and fax
number. The contact should be a person familiar with the correction who can be reached for clarification of any issues. Foreign
manufacturers may find that having a contact person in the U.S. will expedite resolution of fee payment issues.
Reason for Correction:
Select the reason for correction:
-- Typographical error in original engine family or test group name.
-- Overpayment for original family name, please apply the amount to the revised engine family name.
Select this option to transfer an overpayment on the original engine family or test group to the "revised" engine
family or test group. Enter information about the original payment(s) in the Comments box. This will help EPA
confirm the overpayment.
-- Other (explain in comments box)
For any other corrections enter your explanation in the Comments box.
Comments:
Enter any information necessary or helpful in explaining the correction.
Submission:
(1) Forms may be filled out and submitted online at www.Pay.gov.
(2) Forms may be submitted as email attachments to [email protected]
(3) Forms may be submitted by surface mail to:
Environmental Protection Agency- NVFEL
Fees Team
Compliance and Innovative Strategies Division
2000 Traverwood
Ann Arbor, Michigan 48105