(a) Full individual, partnership or corporate name of the manufacturer.

(b) Residence address of the manufacturer, phone number and email address.

(c) Year to which the report applies (reporting year).

(d) The complete Vehicle Identification Number (VIN) of each replica vehicle manufactured.

(e) Vehicle make(s) and model(s).

(f) Replica model year.

(g) Original model year of the replicated vehicle(s).

(h) Total number of replica motor vehicles manufactured during the reporting year.

(i) Images of the front, rear, roof, and side views of the original vehicle(s) replicated, of the vehicle's exterior, and images of the same views of a representative replica manufactured to resemble each original vehicle. Submit also information sufficient to establish that the replica motor vehicle, as manufactured, resembles the body of the original vehicle.

(j) State whether the replica vehicles contain any of the following vehicle safety features: Front or side air bags; lap or lap and shoulder belts; advanced safety systems/passive safety systems (listed with locations); electronic stability control; rear visibility camera system; ejection mitigation.

(k) If the registrant will be manufacturing the same replica motor vehicle(s) in the next calendar year, a notification to NHTSA of which replica motor vehicle(s) will be produced, and a certification that the registrant will produce no more than 325 replica motor vehicles in total. If the manufacturer intends to continue manufacturing replica motor vehicle(s), the manufacturer must also submit information sufficient to establish that their annual world-wide production, including by a parent or subsidiary of the manufacturer, if applicable, is not more than 5,000 motor vehicles, and a statement certifying to that effect, including the total number of motor vehicles produced by or on behalf of the registrant in the 12-month prior to filing the registration.