HUD 306 HUD Manufactured Home Retailer Report-Home Installation

HUD Manufactured Home Retailer Report – Home Installation Information

U.S. Department of Housing and Urban Development Office of Manufactured Housing Programs

OMB Approval No. xxxx-xxxx Expires mm/dd/yyyy

The Manufactured Housing Installation Program Regulations 24 CFR Chapter XX Part 3286 Section 113 requires manufactured home retailers and distributors to report specific information about the installation of a new manufactured home within 30 days from the date of installation. The information collected here will be used in conjunction with manufacturer shipment reports, retail information reports, and other reports as appropriate under these Regulations. Public reporting burden for this collection is estimated to average 0.25 hour per response including the time for reviewing the instructions, searching existing data sources, gathering and maintaining the data as needed, and completing and reviewing the collection of information. Response to the information collection is mandatory. This agency may not collect this information, and you are not required to complete this form, unless the form displays a currently valid OMB control number.

Retailer/Distributor Name & Address		Date (mm/dd/yyyy)
Retailer/Distributor Representative (signature)	Check box if report is for correcting previously reported information

Reporting Period: (mm/dd/yyyy) __________________ through (mm/dd/yyyy) ___________________ Page _____ of _____

Certification Label Number (include all zeros and agency prefix)	Manufacturer’s Serial Number (Including all letters and numbers)	Installation Information				Installation Inspection Information
		Installer’s HUD License Number	Installer Name, Address & Phone Number	Date Installation Work Began (mm/dd/yyyy	Date of Installer’s Certification (mm/dd/yyyy)	Inspector Verification Date (mm/dd/yyyy)	Inspector Name, Address & Phone Number

Distribution: HUD Retailer

Form HUD-306