1/3 IMPORTATION IN FRANCE OF YOUR VAUXHALL (or OPEL

Import Vauxhall v5.0
Réf: dossier (à remplir par GM France): _______/____________/OP
Dossier reçu le (à remplir par GM France) : ____ /_____ /________
IMPORTATION IN FRANCE OF YOUR VAUXHALL (or OPEL) VEHICLE
Before to get the certificate of conformity for registration in France, please fill in this form with
information requested and send it by white mail to the following address:
GM France
Service Homologation
1 à 9 Avenue du Marais - BP 10084
95101 ARGENTEUIL Cedex
Incomplete forms will be returned to the sender. Your request will be processed within: 2-3 weeks
YOUR PERSONAL DATA (Please use CAPITAL LETTERS)
Last Name :
First Name :
Address :
Postal address :
Phone :
Town :
Country :
Email :
WAY OF PAYMENT
Credit card (165 euros): Please write down your bank details below.
Card Number :
Expiry date :
Security code :
Cash mandate (165 euros to GM France)
Obtainable in your local French post office.
Bank cheque (165 euros to GM France)
Cheques with your own name are not accepted! You need to get it from your local bank branch.
 PLEASE ATTACH YOUR PAYMENT WITH THIS COMPLETED FORM.
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Import Vauxhall v5.0
YOUR VAUXHALL (or OPEL) CAR
1 - Thank you to join a both sides copy of the registration certificate.
2 - Vehicle Identification Number :
(17 digits)
First registration date :
J
/ J
M
/
M
A
A
A
A
Registration plate number :
3 - Please provide vehicle VIN plate number (to be found under the bonnet or inside passenger door).
Manufacturer :
European Number * :
Chassis Number :
Permissible total weight :
kg
Gross vehicle weight :
kg
Max font axle weight : 1-
kg
Max rear axle weight : 2-
kg
* The European Type Approval Number is only available for passengers vehicles built after 1998.
4 - Please indicate the engine type (engraved on the block - for example: Z13DTJ or X20XEV) or the
engine litre capacity :
5 - Size of the tyres (found on the tyre itself - for example: 185 / 55 R 15)
FRONT :
/
6 - Energy : Diesel
7 - Gearbox :
R
Petrol
Manual
Number of forward gears :
REAR :
LPG
/
R
Other please specify :
Automatic
(3, 4, 5 or 6)
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Import Vauxhall v5.0
8 - Number of seats :
(2, 3, 4, 5, 6, 7, ...)
- Seat belts for rear seats ?
9 - Number of doors :
Yes
(2, 3, 4, 5, …)
10 - Air-conditioning ?
11 - Type of bodywork :
12 - Category :
No
Yes
No
Sedan
Estate
Coupé
Convertible
People Carrier
Van
Other
Please specify:
Passenger Vehicle
Goods Van
13 - Country of origin :
14 - I hereby certify the information provided in this form is correct and I agree to bear full
responsibility in case of misrepresentation or personal mistakes.
Date :
At :
Signature :
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