![](media/image1.jpeg){width="1.25in"
height="0.6541666666666667in"}National Highway Traffic Safety
Administration![](media/image2.jpeg){width="0.8375in" height="0.8375in"}

Office of Defects Investigation, NVS 217

1200 New Jersey Ave, SE

Washington, DC 20590

\(202\) 366-3348

# Early Warning Reporting Account Application

## For EWR Identification and Password

To be completed by all companies or manufacturers required to submit EWR
data.

Please type or print legibly and return to the Office of Defects
Investigation:

Email <odi.ewr@dot.gov>

FAX (202) 366-7882

IMPORTANT NOTE FOR EQUIPMENT

AND LOW VOLUME MOTOR VEHICLE MANUFACTURERS:

An EWR Account **WILL NOT BE ESTABLISHED** for [motor vehicle equipment
manufacturers]{.underline} or some [low volume motor vehicle
manufacturers]{.underline} until an incident involving one or more
deaths is identified in a claim against and received by the
manufacturer, or in a notice received by the manufacturer. Motor vehicle
equipment and low volume motor vehicle manufacturers (whose aggregate
number of vehicles manufactured for sale, offered for sale, imported or
sold, in the United States, during the calendar year of the reporting
period or either of the prior two calendar years is less than 500) are
responsible only for the reporting of such death claims or notices to
NHTSA. For the claim or notice to be reportable, it must allege or prove
that the death was caused by a possible defect in the manufacturer's
equipment or motor vehicle. The death must have occurred in the United
States, or, if in a foreign country, involved equipment or motor
vehicles that are [identical or substantially similar]{.underline} to
those sold in the United States (Refer to §579.27).

When a motor vehicle equipment or low volume motor vehicle manufacturer
has a death claim or notice to report, the EWR Account Application must
be completed and submitted to NHTSA together with a comment indicating
that a death claim or notice must be reported. An EWR account will then
be established and a manufacturer ID and account password created.

An EWR Account **WILL BE ESTABLISHED** for [low volume motor vehicle
manufacturers]{.underline} who sell or plan to sell motor vehicles in a
foreign country that are [identical or substantially
similar]{.underline} to those sold in the United States. These
manufacturers are responsible for providing NHTSA with an annual list of
such vehicles, and an EWR Account Application must be completed and
submitted (Refer to §579.11). Data on foreign sales are referenced on
page 2 of the EWR Account Application.

Reporting Manufacturer's Account Information

<table>
<colgroup>
<col style="width: 10%" />
<col style="width: 18%" />
<col style="width: 19%" />
<col style="width: 0%" />
<col style="width: 3%" />
<col style="width: 4%" />
<col style="width: 9%" />
<col style="width: 10%" />
<col style="width: 8%" />
<col style="width: 15%" />
</colgroup>
<tbody>
<tr class="odd">
<td colspan="2"><p>Corporate Name</p>
<p>(Reporting Manufacturer)</p></td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">Address (Line 1)</td>
<td colspan="8">     </td>
</tr>
<tr class="odd">
<td colspan="2">Address (Line 2)</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">City, State, Zip</td>
<td colspan="3">     </td>
<td colspan="3">  </td>
<td colspan="2">     </td>
</tr>
<tr class="odd">
<td>Country</td>
<td colspan="2"> United States </td>
<td colspan="3">Other:</td>
<td colspan="4">     </td>
</tr>
<tr class="even">
<td colspan="2">Data Submission Format</td>
<td colspan="2">Excel Format</td>
<td colspan="3"></td>
<td colspan="2">XML Format</td>
<td></td>
</tr>
<tr class="odd">
<td colspan="2">Primary Contact<a href="#fn1" class="footnote-ref"
id="fnref1" role="doc-noteref"><sup>1</sup></a> (Name)</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">Address (Street)</td>
<td colspan="8">     </td>
</tr>
<tr class="odd">
<td colspan="2">Address (City, State, Zip,)</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">Telephone Number</td>
<td colspan="8">(     )     -     </td>
</tr>
<tr class="odd">
<td colspan="2">Fax Number</td>
<td colspan="8">(     )     -     </td>
</tr>
<tr class="even">
<td colspan="2">E-mail Address</td>
<td colspan="8">     </td>
</tr>
<tr class="odd">
<td colspan="2">Secondary Contact (Name)</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">Address (Street)</td>
<td colspan="8">     </td>
</tr>
<tr class="odd">
<td colspan="2">Address (City, State, Zip,)</td>
<td colspan="8">     </td>
</tr>
<tr class="even">
<td colspan="2">Telephone Number</td>
<td colspan="8">(     )     -     </td>
</tr>
<tr class="odd">
<td colspan="2">Fax Number</td>
<td colspan="8">(     )     -     </td>
</tr>
<tr class="even">
<td colspan="2">E-mail Address</td>
<td colspan="8">     </td>
</tr>
</tbody>
</table>
<aside id="footnotes" class="footnotes footnotes-end-of-document"
role="doc-endnotes">
<hr />
<ol>
<li id="fn1"><p><sup>?</sup> EWR Account ID and Temporary Password will
be sent only to the primary contact.<a href="#fnref1"
class="footnote-back" role="doc-backlink">↩︎</a></p></li>
</ol>
</aside>

*Please see pages 4 & 5 for directions on completing the EWR Account
Application*

  ----------------- ------------------ ------------------ ------------------
                    *Reporting         *Parent            *Other
                    Manufacturer*      Corporation\       Affiliate(s) and
                                       (if applicable)*   Relationship (if
                                                          applicable)*

  Name                                                         

  Address                                                      

  Primary Contact                                              

  Contact Telephone                    (     )     -      (     )     -     
  Number                                                  

  Contact E-mail                                               
  Address                                                 

  Brief Description                                            
  of Product                                              

  Intended                                                     
  Reporting                                               
  Categories**²**                                         

  Approximate                                                  
  Annual Production                                       

  Do you sell or    Yes No             Yes No             Yes No
  distribute                                              
  Substantially                                           
  Similar Vehicles                                        
  in foreign                                              
  countries?                                              

  For reporting                                                
  categories                                              
  including Tires,                                        
  Child Restraint                                         
  Systems, or                                             
  Equipment: if                                           
  entity is less                                          
  than 5 years old,                                       
  when did                                                
  production begin                                        
  (mm/yy)?                                                

  For all other                                                
  reporting                                               
  categories: if                                          
  entity is less                                          
  than 10 years                                           
  old, when did                                           
  production begin                                        
  (mm/yy)?                                                
  ----------------- ------------------ ------------------ ------------------

# Directions for Completing the EWR Account Application

+------------------+---------------------------------------------------+
| #### [Head       | #### [Required Data]{.underline}                  |
| ing]{.underline} |                                                   |
+==================+===================================================+
| Corporate Name   | Provide the name of manufacturer reporting EWR    |
|                  | information.                                      |
+------------------+---------------------------------------------------+
| Address, City,   | Provide the primary address of reporting          |
| State, Zip Code  | manufacturer.                                     |
| and Country      |                                                   |
+------------------+---------------------------------------------------+
| Data Submission  | Indicate the intended format in which EWR         |
| Format           | submissions (templates) will be prepared --       |
|                  | either Excel (spreadsheet) or XML (extensible     |
|                  | markup language).                                 |
+------------------+---------------------------------------------------+
| Primary Contact  | Provide the name (First, MI, Last) of the         |
| (Name)           | individual to serve as the manufacturer's primary |
|                  | contact for EWR. This individual should be        |
|                  | familiar with the company's EWR submission and    |
|                  | will serve as ODI's point of contact regarding    |
|                  | all EWR inquiries. **[NOTE]{.underline} --** The  |
|                  | EWR account ID and temporary password will be     |
|                  | sent to this individual [only]{.underline}.       |
+------------------+---------------------------------------------------+
| (Primary)        | Indicate the mailing address, daytime phone       |
| Contact          | number and FAX number for the primary contact     |
|                  | individual. Also, include an email address for    |
| Address,         | this person (whenever possible, electronic        |
| Telephone/FAX    | communication is preferred).                      |
| Number and Email |                                                   |
| Address          |                                                   |
+------------------+---------------------------------------------------+
| Secondary        | Provide the name (First, MI, Last) of the         |
| Contact (Name)   | individual to serve as the secondary or back up   |
|                  | to the manufacturer's primary contact for EWR.    |
|                  | This individual should also be familiar with the  |
|                  | company's EWR submission and will serve as ODI's  |
|                  | second point of contact regarding all EWR         |
|                  | inquiries. **[NOTE]{.underline} --** The EWR      |
|                  | account ID and temporary password issued by ODI   |
|                  | will [not]{.underline} be sent to this            |
|                  | individual. The [manufacturer]{.underline} may    |
|                  | provide this person with the information, if      |
|                  | desired.                                          |
+------------------+---------------------------------------------------+
| (Secondary)      | Indicate the mailing address, daytime phone       |
| Contact Address, | number and FAX number for the secondary contact   |
| Telephone/FAX    | individual. Also, include an email address for    |
| Number and Email | this person (whenever possible, electronic        |
| Address          | communication is preferred).                      |
+------------------+---------------------------------------------------+
| ***Page 3        |                                                   |
| Data***          |                                                   |
+------------------+---------------------------------------------------+
| #### [Head       | #### [Required Data]{.underline}                  |
| ing]{.underline} |                                                   |
+------------------+---------------------------------------------------+
| Reporting        | **Provide answers to the questions explained      |
| Manufacturer     | below. This data will be used solely to assist    |
|                  | ODI with creating the EWR account.**              |
| \[Column One\]   |                                                   |
+------------------+---------------------------------------------------+
| Brief Product    | Provide a brief description of the types of       |
| Description      | products manufactured, upon which reporting will  |
|                  | be based (i.e., "enclosed cargo trailer" or "boat |
|                  | trailer"). For motor vehicle equipment, describe  |
|                  | with sufficient detail to clearly illustrate the  |
|                  | function or applicability of the equipment (i.e., |
|                  | "door hinge", as opposed to "structural           |
|                  | component").                                      |
+------------------+---------------------------------------------------+
| ####  [Head      | #### [Required Data]{.underline}                  |
| ing]{.underline} |                                                   |
+------------------+---------------------------------------------------+
| **Intended       | Identify all reporting categories for which EWR   |
| Reporting        | information will be submitted, choosing from the  |
| Category**²      | following: [light vehicles]{.underline},          |
|                  | [medium-heavy vehicles/buses]{.underline},        |
|                  | [motorcycles]{.underline},                        |
|                  | [trailers]{.underline}, [tires]{.underline},      |
|                  | [child safety systems]{.underline},               |
|                  | [equipment]{.underline}, or [low volume (below    |
|                  | threshold) vehicle production]{.underline}.       |
+------------------+---------------------------------------------------+
| Approximate      | State the [approximate]{.underline} total         |
| Annual           | aggregate annual production for each reporting    |
| Production (per  | category listed.                                  |
| Reporting        |                                                   |
| Category)        |                                                   |
+------------------+---------------------------------------------------+
| Distribute/Sell  | Indicate (Yes/No) whether or not the reporting    |
| Substantially    | manufacturer distributes or sells vehicles in     |
| Similar Vehicles | foreign countries that are [identical or          |
| in Foreign       | substantially similar]{.underline} to any         |
| Countries as     | vehicles sold in the U.S.                         |
| Those Sold in    |                                                   |
| the U.S.         |                                                   |
+------------------+---------------------------------------------------+
| Year/Month       | For manufacturers of tires or child restraint     |
| Production Began | systems that began production or were acquired    |
| for              | less than 5 years ago, identify the month and     |
| Manufacturers of | year that production began or liability was       |
| **Tires and      | assumed.                                          |
| Child Restraint  |                                                   |
| Systems** Less   |                                                   |
| Than 5 Years Old |                                                   |
+------------------+---------------------------------------------------+
| Year/Month       | For vehicle manufacturers that began production   |
| Production Began | or were acquired less than 10 years ago, identify |
| for Vehicle      | the month and year that production began or       |
| Manufacturers    | liability was assumed.                            |
| Less Than 10     |                                                   |
| Years Old        |                                                   |
+------------------+---------------------------------------------------+
| Parent           | In the appropriate column identify: [any          |
| Corporation      | corporation which the reporting manufacturer is a |
|                  | subsidiary or division of, or an                  |
| \[Column Two\]   | importer/distributor for]{.underline} (including  |
|                  | foreign companies). Include the parent            |
|                  | corporation's name, full mailing address, and     |
|                  | primary contact person, including that            |
|                  | individual's telephone number and email address,  |
|                  | and the reporting manufacturer's relationship to  |
|                  | the parent corporation. Provide answers to the    |
|                  | subsequent questions as described above. Page 2   |
|                  | may be duplicated if additional columns are       |
|                  | required.                                         |
+------------------+---------------------------------------------------+
| Other            | In the appropriate column identify: any           |
| Affiliate(s)\    | subsidiary, division, brand name, or              |
| and Relationship | importer/distributor(s) [for which the reporting  |
|                  | manufacturer intends to submit EWR                |
| \[Column Three\] | information]{.underline}. Include the company's   |
|                  | name, full mailing address, and primary contact   |
|                  | person, including that individual's telephone     |
|                  | number and email address, and its relationship to |
|                  | the reporting manufacturer. Provide answers to    |
|                  | the subsequent questions as described above. Page |
|                  | 2 may be duplicated if additional columns are     |
|                  | required.                                         |
+------------------+---------------------------------------------------+

Refer to 49 CFR §579 Subpart C for\
additional information on the submission of EWR reports.