Application for Brake Hose Manufacturer Identification

If you are already registered with NHTSA please enter your Manufacturer ID (you can find it in the MID app). This will help you pre-populate forms with existing data.

Manufacturer ID

You must ensure the accuracy of your submission. Any inaccuracy may result in a rejection of your submission or delay processing of your submission.

Fields marked with * are required

Manufacturer Company Full Legal Name

Manufacturer Country

Manufacturer State/Province

Manufacturer City

Address

Submitter's Business Email

Verify Submitter's Business Email

Submitter's Business Phone

Cover Letter / Submission Description

Please identify whether this submission is a new record or an update to an existing record.
If this is an update, you MUST identify all changes from the existing record.

Maximum 25,000 characters. Clear Cover Letter

Cover letter is required

Select a Cover Letter file No file selected

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Application for Brake Hose Manufacturer Identification