File a Portable Form Safety Complaint

Request a Portable Form

Fill in your email address in the box below and, optionally, provide your name and zip code in the corresponding boxes. An email will be sent to confirm your request. Click on the confirm link in the email and a PDF form will be sent to your email address.

NOTE: The free Adobe Acrobat Reader is required to open and use this form and can be downloaded at http://get.adobe.com/reader/

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NOTE: You can use the Track Form tab to check on the status of your complaint at any point in the process.

Please use the Getting Started tab at the top to review the overall process and the FAQ (Frequently Asked Questions) tab to answer questions you may have on email requests and privacy issues.

Upload your Portable Form

Use this page to submit your completed Portable Form for processing. Begin by clicking the Browse button below and navigating to your completed form. After locating and selecting your form, click the Upload button.

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A verification will be sent to the email address on file for this form. This only serves to inform you that we received your complaint. Another email will be sent when your complaint has been successfully processed and entered into our system.

Track the Status of your Portable Form

To check the current status of your Portable Form, fill in the email address used and the Temporary Complaint Number (TCN) of your Portable Form in the boxes below.

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Getting Started

Overview

The Portable Form lets you file a safety complaint about your vehicle with NHTSA. The form allows you to provide a minimal set of information necessary for us to record your vehicle safety complaint. The information from your Portable Form will be used with other similar complaints to look at general trends that could lead to more in-depth investigations of vehicle safety issues.

NOTE: A more detailed, online Complaint form is available at http://www-odi.nhtsa.dot.gov/ivoq/online.cfm

Three easy steps for filing your Vehicle Safety Complaint

1. Request a PDF version of the Portable Form be sent to your email address.
2. Complete the Portable Form.
3. Upload your Portable Form to NHTSA.

STEP 1. Request a Portable Form

1. Fill in the fields in the "Request a Portable Form" section on the Portable Form Home page and then select the "Request Form" button.
2. You will receive an email with a link to confirm your request.
   1. Select the confirm link in this email and this will take you to our Portable Form Welcome Page. An email with the Portable Form as an attachment will then be sent to your email address.

NOTE: The free Adobe Acrobat Reader is required to open and use this form and can be downloaded at http://get.adobe.com/reader/. You must have JavaScript enabled in the Reader. This can be set on the Edit > Preferences > JavaScript panel.

STEP 2. Complete the Portable Form

The Portable Form that you received from NHTSA is your own with your email address filled in. For easier referencing save the form to your local machine, open it and fill it out. Instructions are included with the form.

1. Please fill in as much information as you can.
2. The Vehicle Identification Number (VIN) is unique to each vehicle and is comprised of 17 characters. You may use the "Test your VIN" option on the form to verify the validity of the VIN number.
3. You may choose your vehicle Make or enter it in the vehicle Make field. Also enter the specific Model of your vehicle and select or enter its model Year in the corresponding fields.
4. Use the Incident Information fields to provide details of the incident(s). If you have encountered multiple incidents, enter the first occurrence date, failure mileage, etc.
   1. Use the Description field to provide a brief narrative of the events leading up to, during, or after the incident that caused your safety concern. Specify any vehicle parts that may have contributed to your complaint issue.

If you need assistance with filling out your Portable Form, please call the Vehicle Safety Hotline toll-free at 1-888-327-4236.

STEP 3. Submit the Portable Form

After completing your form, you must save and then upload the form to have your complaint information entered in our system.

• Save the form to an easily accessible location on your computer using the first link provided at the top of the Portable Form.
• Upload the form by accessing our Upload Web page using one of these methods:
  • By selecting the ?Upload Form? tab above,
  • By using the link: https://www-odi.nhtsa.dot.gov/portable/index.cfm#upload,
  • By using the link provided in the email you received with the form, or
  • By using the link provided at the top of the Portable Form.
  
  You can then Browse to locate your saved Portable Form and upload it to our system.

Upon receipt, NHTSA Office of Defects Investigation (ODI) processes and validates the completed Portable Form. Once your information is successfully validated, it is entered into the NHTSA database and an official identification Number (ODI Number) will be assigned. An email with the ODI Number will be sent to the email address on file.

Please review the FAQ section by selecting the FAQ tab to view common questions and answers about the Portable Safety Complaint process.

STEP 4. (Optional) Check the status of your Portable Form

After you have confirmed your request for a Portable Form and have received a Temporary Complaint Number (TCN), you can check the status of your Portable Form on the Track Form tab. You will need to enter the email address used for your request and the TCN and then select the Get Status button.

A status message will be shown indicating that your Portable Form has not yet been received, that it is being reviewed, or that processing has been completed. Additional information may be provided, depending on the status. You will receive an error message if the combination of the email address and TCN is not recognized in our system.

Frequently Asked Questions (FAQ)

Before Filing your Portable Form
Questions about the Portable Form
Submitting the Portable Form

Before Filing your Portable Form

1. Why do I need to confirm my request or email address?
   1. To prevent the improper use of the email addresses and to prevent spam we request that you verify and confirm your email address. After you have verified your email address and request, we will send the Portable Form to you in an email as a PDF attachment.
2. What if I do not receive the Portable Form at my email address?
   1. The Portable Form with your email address is sent to you within two hours after you submit your request on the NHTSA SaferCar website. The Portable Form is sent from the PortableSafetyComplaint@dot.gov address. Please check your spam folder for an email from this address as the email may have been routed to that folder.
3. How many Portable Forms may I request?
   1. You may request more than one Portable Form from your email address. Each request is marked with a unique temporary complaint number (TCN) and is marked as such in the email communication.
4. Do I need to request an Portable Form for each complaint that I want to file?
   1. Yes. One Portable Form may be used to file a complaint about one vehicle only. If you have more than one vehicle safety complaint to make to the agency, please request a separate Portable Form.
5. Can "my" Portable Form be used by my family/friends?
   1. No. NHTSA sends a personalized version of the Portable Form to the requestor's email address and it is marked with a temporary complaint number. If you share this personalized form with your family/friends then all of their complaint information will be incorrectly attributed to you, and this is not recommended.
6. What version of PDF Reader do you support?
   1. The Portable Form is an editable PDF form and works with Adobe Reader 8.0 or later.
7. Can I cancel the Portable Form request?
   1. If you do not want to complete and submit the Portable Form, you may simply ignore the confirmation email when it arrives. You do not need to do anything to cancel the request. Your request expires automatically 60 days after your initial request. We will, however, send a reminder 2 days after you request the form.
8. Can I change the information on a submitted Portable Form and re-submit it?
   1. No. You may, however, contact the NHTSA Office of Defects Investigation (ODI) by telephone or email and provide that information.
9. Can I retract the Portable Form after submitting it?
   1. There is no automatic way to retract your complaint after you submit it to the NHTSA. You may request that NHTSA remove your complaint from the database by writing to us. Note that your complaint may be published in the public NHTSA database and it could take up to 7 days to delete it from this public database.
10. Can I use this complaint form for filing non-vehicle safety complaints?
    1. No. For filing safety complaints related to Tires, Child Safety Seats or Equipment please use NHTSA's online complaint form at http://www-odi.nhtsa.dot.gov/ivoq/.

Questions about the Portable Form

1. How do you use my information?
   1. Your response and information may be used to assist the NHTSA in determining whether a manufacturer should take appropriate action to correct a safety defect. If the NHTSA proceeds with administration enforcement or litigation against a manufacturer, your response, or statistical summary thereof, may be used in support of the agency's action.
2. What is your privacy policy?
   1. NHTSA's privacy policy can be found at http://www.nhtsa.gov/Privacy.
3. What is a Vehicle Identification Number (VIN) and why do I need to Test my VIN?
   1. The VIN is a 17-character identifier found in several places on your vehicle and is recorded on your registration or insurance card. As the VIN uniquely identifies your vehicle and is a long string of characters, it is advisable to test the validity of the VIN to check for common errors that might have been introduced while entering the information on the form.
4. What if I do not know some of my Vehicle Information?
   1. Please enter as much information as you know about your vehicle such as Make, Model, and Model Year. We recommend you enter all the Model information such as AWD, XL, etc.
5. I have many incidents to list here. How do I file all of that information?
   1. If you have encountered more than one occurrence of an incident, then please enter the details about your first incident. You may enter approximate details such as failure date and mileage. You may also use the Description field to write the narrative description about these incidents.
6. I do not know what the failed components are. How do I fill in this information?
   1. Some examples of failed components are brakes, engine, steering, etc. The form provides a list of components for your use and if you cannot identify or associate your incident with one of these components, then you may choose "Unknown or Other" as an option. You may also use the Description field to describe the problem to the best of your knowledge.
7. Is there a way to contact the agency and provide more information?
   1. Yes. You may contact NHTSA ODI using the public website (http://www.safercar.gov) contact form or via our phone number. This contact information is provided on the Portable Form as well.
8. Is it safe to provide my personal information on the complaint?
   1. Yes. We do not share your personal information with the general public. This information is never transferred to the public databases. We may share your information with the applicable vehicle manufacturer during an investigation or recall in accordance with the routine uses described in the agency's Privacy Act notice. See 49 FR 53971 (Sept. 3, 2004).
9. Can I save the form and submit it later?
   1. Yes. You may save the form, with some or all of the information filled in, to your computer and submit it to NHTSA ODI at a later point in time. The form does not have an expiration date. We will, however, send a reminder 3 days after sending you the form.
10. What is a temporary complaint number (TCN)?
    1. The TCN allows NHTSA ODI to track your complaint in our system until your complaint information is successfully saved into the secure database. Once the complaint is successfully saved, you will receive an ODI Number (see "When do I get a complaint (ODI) number?" in the section below for more information). The TCN is 9 characters long and an example number looks like GCN3-34619.

Submitting the Portable Form

1. I do not know all of the information that is being requested. Can I still submit the form?
   1. Yes. We value your information and would like to receive as much information as you may have. If you would like to complete your information at a later point in time, you may do so by contacting NHTSA ODI.
2. Can I save the form and send it in later?
   1. Yes. See an earlier question in the section above.
3. How can I submit the completed form to NHTSA ODI?
   1. Option 1: Save the form and then upload it directly to us using the following link:
      https://www-odi.nhtsa.dot.gov/portable/index.cfm#upload or use the link provided in the email you receive with the form.
   2. Option 2: Use the "link" provided at the top of the form.
   3. Upon receipt, NHTSA Office of Defects Investigation (ODI) processes and validates the completed Portable Form. Once the Safety Complaint information is successfully validated, the Complaint information is entered into the NHTSA database and a Complaint Number (ODI Number) will be assigned. An email with the ODI Number will be sent to the email address on file.
4. How can I check the status of my Portable Form?
   1. Enter the email address used for your original request and the associated TCN in the input boxes on the Track Form tab and then select the Get Status button. A message will be given showing the current status of your Portable Form. An error message will be given if the email address/TCN is invalid.
5. When do I get to hear about my complaint?
   1. We will contact you, via email, with a Complaint Number as soon as we enter your complaint information in our secure database. Your complaint will be viewable on the public website within a few business days of that notification.
6. How is my complaint shown on the NHTSA public website?
   1. Only your non-private complaint information is shown on the public website. Your personal information is never shown on the public website. The complaint Description is shown as is and hence we suggest that you do not enter any personal information (name, street/email address, phone number, Social Security Number, Vehicle Identification Number (VIN), etc.) in the complaint Description field.
7. When do I get a complaint (ODI) number?
   1. You will receive a Complaint Number via email as soon as we successfully enter your complaint information in our secure database. We verify the data for completeness or accuracy before we save the complaint information. These tests include, but are not limited to, verification of vehicle Make, Model or Year information, VIN, etc.

Notes

Sample form

NOTE: only a sample for mockup
Click on image for larger view.