HUD-203 Lost Label Report

Lost Label Report
IPIA/Manufacturer/Losing Party

U.S. Department of Housing and Urban Development
Office of Regulatory Affairs and Manufactured Housing

OMB Approval No. 2502-0233
expires 10/31/2006

(Must be completed within 5 days of discovery or loss)
The Manufactured Housing Procedural and Enforcement Regulations 24 CFR Part 3282 Section 501 authorizes the Secretary to take such actions to oversee
the system as the Secretary deems appropriate. This form requires the Secretary Production Inspection Primary Inspection Agency (IPIA) to report any
lost labels or salvagfed manufactured home units. The information collected here will be used to request such lost lagels or salvaged units. Public reporting burden for this collection of information is estimated to average 0.5 hours per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the collected information. Response to this information collection is mandatory under 42 U.S.C. 5413(c)(3). This agency may not collect this information, and you are not required to complete
this form, unless it displays a currently valid OMB control number.
Manufacturer’s Name & Address

Factory Address

Manufacturer’s Representative

Phone

Date (mm/dd/yyyy)

Lost Labels
(to be completed by manufacturer or losing party)

Quantity ___________________ certification labels. Date certification label affixed to unit _________________________
(mm/dd/yyyy)

New certification label number affixed to unit ___________________________ Date loss discovered ________________
(mm/dd/yyyy)

Certification label numbers _______________________ through and including _________________________________
Name and address of person who last had possession of certification label(s) when loss was discovered:
Name ___________________________________________________________________________________________
Address _________________________________________________________________________________________
Name and address of person who discovered loss:
Name ___________________________________________________________________________________________
Address _________________________________________________________________________________________
Police or private investigator contacted or used:
❑

Yes

By Whom?__________________________________________________________ Date _________________
(mm/dd/yyyy)

Results (include police or investigator reports):

❑

No

Why?

Distribution
Original - HUD’s Contracting Agent
Copies to: IPIA
Manufacturer
Previous editions obsolete

page 1 of 2
Form HUD-203 (10/20/2006)

Explanation of Loss
(to be completed by manufacturer or losing party)

Losing party must provide a detailed written explanation discussing the events that led to the lost certification label(s), and
what efforts were made towards its (their) recovery.

IPIA Recommendations
(to be completed by IPIA)

Make a detailed statement setting forth your analysis of circumstances surrounding the loss. Give specific reasons for
recommendation to HUD if free replacement of a lost certification label is requested. Submit complete package to HUD’s
Contracting Agent. It will forward the documentation to HUD, with its determination for HUD’s analysis and final decision.

IPIA Authorized Label Administrator ______________________________________________________
(signature)

If Unit is Sold for Salvage
(to be completed by manufacturer)

Name of salvage company __________________________________________________________________________
Owner __________________________________________________________ Phone _________________________
Address _________________________________________________________________________________________
If a labeled unit is sold to a salvage company, its certification label must remain with the manufacturer.
Under no conditions will a certification label remain attached to a unit sold for salvage.

Determination
(to be completed by HUD’s Contracting Agent)

❑ Approved

❑ Disapproved

Reason _________________________________________________________________________________________
_______________________________________________________________________________________________
❑ Additional information required by

_______________________________________________________________
(signature)

❑ Additional effort to secure certification label required by _________________________________________________
HUD’s Contracting Agent (Label Coordinator) ___________________________________ Date ____________________
(mm/dd/yyyy)

Distribution
Original - HUD’s Contracting Agent
Copies to: IPIA
Manufacturer
Previous editions obsolete

page 2 of 2

Form HUD-203 (10/20/2006)