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. 2502-0578
Expires 04/30/2018

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) __________________
Certification
Label Number
(include all zeros and
agency prefix)

Manufacturer’s
Serial Number
(Including all letters
and numbers)

through (mm/dd/yyyy) ___________________

Page _____ of _____

Installation Information
Installer’s
HUD License
Number

Installer Name, Address & Phone Number

Installation Inspection Information
Date
Installation
Work
Began
(mm/dd/yyyy

Date of
Installer’s
Certification

Inspector
Verification
Date

(mm/dd/yyyy)

(mm/dd/yyyy)

Inspector Name, Address & Phone Number

Distribution:
HUD
Retailer
Form HUD-306