Connected Vehicle Technology Regulatory Compliance Waiver Request Form
Use this form to request a compliance waiver for a connected vehicle technology project and provide the details needed for review.
Requester and Organization Information
Requester Name
*
First Name
Last Name
Job Title or Role
*
Organization / Company Name
*
Work Email
*
example@example.com
Work Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mailing City, State/Province, Country
*
Primary Contact Person (if different from requester)
Connected Vehicle Technology Details
Technology / Project Name
*
Vehicle System or Platform Type
*
Please Select
Passenger Vehicle
Commercial Truck
Transit Bus
Emergency Vehicle
Motorcycle
Off-Highway Equipment
Infrastructure Unit
Fleet Platform
Other
Connected Vehicle Function or Feature
*
Deployment Stage
*
Please Select
Pilot
Testing
Limited Release
Full Deployment
Concept / Planning
Other
Intended Operational Environment
*
Please Select
Public Roadway
Closed Track
Controlled Test Facility
Mixed Environment
Laboratory / Simulation
Other
Technology Description and Request Purpose
*
Compliance Waiver Request Details
Compliance Requirement or Standard
*
Reason Waiver Is Needed
*
Requested Waiver Scope
*
Requested Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
End Date or Duration
Affected Jurisdictions or Regions
*
North America
Europe
Asia-Pacific
Latin America
Middle East
Africa
Global
Other
Operational Controls or Mitigations in Place
Request Urgency
*
Standard review
Expedited review
Urgent operational deadline
Impact, Risk, and Supporting Information
Expected impact if the waiver is granted
*
Expected impact if the waiver is denied
*
Safety and operational risk considerations
*
Supporting documents or attachments
Upload a File
Drag and drop files here
Choose a file
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Additional notes or exceptions
Submit Waiver Request
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