HUD-303 Refunds Due Manufacturer

Refunds Due Manufacturer
(Unused Labels)

U.S. Department of Housing and Urban Development OMB Approval No. 2502-0233
Office of Manufactured Housing Programs

expires 08/31/2019

The Manufactured Housing Procedural and Enforcement Regulations 24 CFR Chapter XX Part 3282 Section 552 requires manufacturers to report certification label
usage on a monthly basis. The information collected here will be used to refund manufacturers for unused certification labels as paid according to Section 210.
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 collection of information. Response to this information
collection is mandatory. 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. There are no assurances of confidentiality.

Manufacturer’s Name & Address

Factory Name & Address

Manufacturer’s Representative

Phone

Date (mm/dd/yyyy)

Refunds
(to be completed by manufacturer)

We hereby request that our IPIA, ____________________________________________________________________ ,
for the above manufacturing factory, advise HUD’s and or HUD’s monitoring agent that we have returned the following
manufactured home certification labels. These labels have never been affixed to a manufactured home.
Certification Labels _____ - __________ through & including _____ - __________ = __________ (Quantity)
Certification Labels _____ - __________ through & including _____ - __________ = __________ (Quantity)
Certification Labels _____ - __________ through & including _____ - __________ = __________ (Quantity)
Total Labels Returned: ____________ x $100.00 = $ ________________
The above designated certification labels are being returned because:


The facility has been closed effective:_____________________



The facility’s IPIA has been changed to:_______________________ , effective_________________



Other:

(mm/dd/yyyy)

(mm/dd/yyyy)

IPIA Verification of Credit Due Manufacturer
(to be completed by IPIA)

The above designated manufactured home certification labels were received by our office on ____________________ .
This report and the labels have been analyzed and found to be accurate.
(mm/dd/yyyy)
The labels (will be/will not be) reassigned. The refund due will be  credited to ____________________ or
(manufacturer label code)

 refund needed from HUD.
IPIA Authorized Label Administrator ______________________________ Date: ____________
(signature)

(mm/dd/yyyy)

HUD Refund Processing

(by HUD or HUD’s monitoring agent)

Date received ____________________ Date forwarded to HUD: ______________ by ____________________________
(mm/dd/yyyy)
Previous editions obsolete

(mm/dd/yyyy)
Form HUD-303 (09/16)