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APPLICATION FOR WMI CODE
*
DATE
April 16, 2024
*
1. Is this the first request that has been made for a WMI from someone with your company?:
No
Yes
*
2. Is the vehicle complete when it leaves your company?:
No
Yes
*
3. Is the vehicle for on road use?:
No
Yes
*
4. Is this a replica vehicle?:
No
Yes
*
5. Do you manufacture more or less than 900 vehicles per year?:
More
Less
*
Owner/President of Company
*
Contact Name:
*
Company Name:
*
Company Information
*
Address
*
City
*
Country/Region
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory (the)
British Virgin Islands
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands (the)
Colombia
Comoros (the)
Congo (the Democratic Republic of the)
Cook Islands (the)
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (the) [Malvinas]
Faroe Islands (the)
Fiji
Finland
France
French Guiana
French Southern Territories (the)
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (the)
Honduras
Hong Kong, China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic Peoples Republic of)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao, China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Republic of Congo
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension
Saint Kitts and Nevis
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Isl
South Korea
South Ossetia
South Sudan
Spain
Sri Lanka
St Lucia
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Tahiti
Taiwan (Province of China)
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (the)
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Upper Volta
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Western Samoa
Yemen Arab Republic
Zambia
Zimbabwe
Åland Islands
*
State / Province
*
Zip Code
*
Plant Information
*
Address
*
City
*
Country/Region
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory (the)
British Virgin Islands
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands (the)
Colombia
Comoros (the)
Congo (the Democratic Republic of the)
Cook Islands (the)
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (the) [Malvinas]
Faroe Islands (the)
Fiji
Finland
France
French Guiana
French Southern Territories (the)
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (the)
Honduras
Hong Kong, China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic Peoples Republic of)
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao, China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Republic of Congo
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension
Saint Kitts and Nevis
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Isl
South Korea
South Ossetia
South Sudan
Spain
Sri Lanka
St Lucia
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Tahiti
Taiwan (Province of China)
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (the)
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Upper Volta
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Western Samoa
Yemen Arab Republic
Zambia
Zimbabwe
Åland Islands
*
State / Province
*
Zip Code
*
Phone Number:
*
Fax:
*
Email:
*
Trade Name of Vehicle:
*
Type of Vehicle:
Passenger car
Multipurpose passenger vehicle
Truck
Bus
Motorcycle
Motor driven cycle
Trailer
Low-speed vehicle
*
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