3520-8 Application for Final Admission of Nonconforming Importe

Form Approved OMB 2060-0095

United States Environmental Protection Agency
Application for Final Admission of Nonconforming Imported Vehicle or Engine

1. Port of entry:

2. Entry date
(mo/dy/year) :

5. Date of original manufacture
(mo/year):

3. Customs entry number:

4. Vehicle Identification Number (VIN), or engine serial number:

6. Original manufacturer:

7. Model:

8. Declaration code (letter or
box number from EPA form
3520-1 or 3520-21):

Names, Addresses, and Telephone Numbers of Relevant Parties
9. Importer (ICI) name and address:

11. Address of vehicle/engine storage location (no
P.O. boxes):

10. Owner name and address:

Telephone number:

Telephone number:

12. Person to receive oral or written notification that EPA has not approved
final admission:

13. Telephone number for item 12:

15. EPA certificate no., model year, and expiration date of certificate
applicable to this vehicle:

16. Engine family name on certificate:

17. Designate the provisions
under which the vehicle was
imported (mark X in one box):

Certified vehicles: Write the sequence number in this box of vehicles
identical to the certified vehicle, beginning with the first one imported, which
is the certified prototype. Ordinarily every third sequence number must have
test results in item 18 (i.e., 1st, 4th, 7th, etc.). Do not count mod/test vehicles.
Leave blank only if this vehicle is a mod/test vehicle.

Certified vehicle imported
Under 40 CFR 85.1505
Modification/Test Vehicle
Imported under 40 CFR 85.1509.
You must enter test results for
each vehicle in item 18.

14. Modification date:

All vehicles: For fee purposes, write the sequence number of the vehicle
covered by the currently valid certificate listed in item 15. Count both
certified and mod/test vehicles. Do not leave blank.

18. Test Results (where applicable)
Name, address and phone number of test laboratory:
Initial test results: (indicate applicable units and pollutants)

Test Results

Deterioration factors
(as applicable)
Date of test
50K

full
useful
life

Test results adjusted
by the deterioration
factor and rounded to
two significant figures
using ASTM E 29-67
rounding procedures:

50K

full
useful life

Emission standards

50K

full
useful life

Specify mileage used for
full useful life
______K mi

NMOG, NMHC, HC
or NOx+HC
g/mi or g/kW-hr

g/mi
or g/kW-hr

CO
g/mi or g/kW-hr

g/mi
or g/kW-hr

NOx
g/mi or g/kW-hr

g/mi
or g/kW-hr

Evap.
g/test

g/test

HCHO or Particulates
g/mi or g/kW-hr

g/mi
or g/kW-hr

19. Combined Fuel Economy. For passenger cars and trucks only - report the combined fuel economy value (harmonic average calculated per 40 CFR 600.51308(a)(2)) from the last city and highway test for each vehicle tested:

EPA Form 3520-8 (Rev. 4-10)

Previous versions are obsolete

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20. Place an “X” in only one box

I certify that the vehicle or engine has been modified in accordance with the provisions of a currently valid certificate of conformity. If applicable, a
Federal Test Procedure was performed on the vehicle or engine in accordance with procedures in 40 CFR Part 86 or Part 89 as applicable at a
laboratory in the U.S. (40 CFR 85.1505(a)(2)(ii), 89.605(a)(2)(ii)).
I certify that the vehicle or engine has been modified and the Federal Test Procedure was performed on the vehicle or engine in accordance with
procedures in 40 CFR Part 86 or 89 at a laboratory in the U.S. For a vehicle, the emission testing and development of Fuel Economy data were
performed after modification to Department of Transportation safety standards. (40 CFR 85.1509(g)(2), 89.609(b)(2)).
I certify that the vehicle or engine has been modified in accordance with the provisions of a currently valid certificate of conformity. EPA has approved
the plan for me to receive information concerning OEM running changes that affect emissions and therefore testing was not required. (40 CFR
85.1505(a)(2)(i), 89.605(a)(2(i)).

21.

I certify that the following statements are true:

I certify that as the certificate holder I have provided or will provide to the purchaser or owner of the vehicle or engine, as applicable:
(1) written instructions for maintenance and use as required by 40 CFR 85.1510(a), 89.610(a);
(2) an emissions warranty as described in 40 CFR 85.1510(b), 89.610(b), Part 85 Subpart V and Clean Air Act sections 207(a) and (b);
(3) an emission label as required by 40 CFR 85.1510(c) and 89.610(c);
(4) a fuel economy label as required by 40 CFR 85.1510(d) and 40 CFR Part 600 Subpart D.
I certify that as the certificate holder I have complied with the applicable provisions of the Energy Act of 1978, 26 USC 4064 (gas guzzler tax) and for vehicles not
owned by me I have provided the applicable tax forms to the owner;
I have complied with the requirements of 40 CFR 80.24 as applicable to affix applicable unleaded fuel labels;
I am responsible for the vehicle or engine compliance with Federal emission requirements regardless of whether I own the vehicle or engine.
I certify that I have read and understand the warning below regarding the submission of false or fraudulent statements or concealing a material fact, and the
prohibited acts in 40 CFR 85.1513, 89.612 as applicable, and that the information I have provided is correct.
I understand that EPA Enforcement Officers are authorized to conduct inspections or testing otherwise permitted by 40 CFR Parts 85 or 89 or other applicable
provisions of the law.
I will hold this vehicle or engine at least 15 working days from the date of EPA’s receipt of the final admission information unless otherwise notified by EPA.
I have paid the applicable Motor Vehicle and Engine Compliance Program fee for this vehicle and submitted the Fee Filing Form (EPA Form 3520-29, available at
www.EPA.gov/OTAQ/fees.htm or www.Pay.gov ) with the appropriate payment. Submit the fee form according to the directions on the fee form.
22. What is the retail sales price or fair retail market value of this vehicle?
23.

I request a revised certificate. (Attach a copy of your submitted Fee Filing Form).
The number of vehicles that may be imported under a certificate is written
on your certificate. If this vehicle exceeds that limit you must request
a revised certificate and pay the appropriate fee prior to final importation.

Warning: Any person who knowingly makes any false or fraudulent statement, or omits or conceals a material fact can be fined up to $250,000 or imprisoned
for up to 5 years, or both (18 United States Code 1001). This form is required to be submitted to EPA under 40 CFR 85.1505, 85.1509, 89.605, and 89.609.

24. I certify that the information on this form is
true to the best of my knowledge.

Print or type name

Date signed

Signature of ICI corporate officer:

Mailing Instructions
Fax this form Attn: Final Admissions, to
734-214-4869
or mail to:
US EPA
Attn: Final Admissions of ICI Vehicles
2000 Traverwood
Ann Arbor, MI 48105

Paperwork Reduction Act Notice

This information is collected to ensure that motor vehicles and engines imported into the U.S. conform with applicable emission requirements. Responses to this
collection are mandatory (40 CFR 85.1501 et seq., and Clean Air Act Sections 203 and 208). Information submitted to the Agency under a claim of confidentiality will be
safeguarded according to policies set forth in Title 40, Chapter 1, Part 2, Subpart B. The public reporting and recordkeeping burden for this collection of information is
estimated to average 30 minutes per response. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any
suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Do not send the completed form to this address.
For EPA use only
Date final admission form received:

EPA Form 3520-8 (Rev. 4-10)

Previous versions are obsolete

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