HUD-101 Request for Labels (order control)

IPIA Request for Labels
(order control)

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

OMB Approval No. 2502-0233
(expires 11/30/2022)

The Manufactured Housing Procedural and Enforcement Regulations 24 C.F.R. Chapter XX Part 3280 Section 11 and Part 3282 Sections 204 and 205
requires manufacturers to affix a certification label. Manufacturers report affixed labels through reports required by 24 C.F.R. Chapter XX Part 3282 Sections
209 and 552, providing usage data on a monthly basis. In turn the Inspection Primary Inspection Agencies (IPIAs) are required to monitor and provide
Manufacturers a supply of certification label and request them from HUD in accordance with 24 C.F.R. Chapter XX Part 3282 Section 362(b). The information
collected here will be used to monitor home distribution, collect fees, and reimburse parties as appropriate under these Regulations. 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
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.
Privacy Notice:
HUD collects information in accordance with 42 U.S.C. 5413(c)(3) of the National Manufactured Housing Construction and Safety Standards Act of 1974 which
requires manufacturers, under 42 U.S.C. 5413(f), to maintain records, make reports and provide such information as HUD requires to determine whether the
manufacturer is in compliance with the standards established under 42 U.S.C. 5403.
Purpose of this collection is necessary for accurate dispensation of program benefits and credits. Failure to comply with these regulations may subject the party
in question to the civil and criminal penalties provided for in section 611 of the Act, 42 U.S.C. 5410. While HUD generally only discloses this data in response to
a Freedom of Information or audit request, any information collected pursuant to 42 U.S.C. 5413(b), (c), (f), or (g) which contains or relates to a trade secret that
would result in a substantial competitive disadvantage if disclosed shall be considered confidential and shall not be further disclosed except as required or
permitted under 42 U.S.C. 5413(h).
IPIA Name

IPIA Address

Authorized IPIA Label/Administrator

Phone

Date (mm/dd/yyyy)

Request for Labels
(to be completed by IPIA)

We hereby request

certification labels for our on-hand inventory. Currently, our inventory is
(Quantity)

certification labels on-hand. Based on our current rate of certification labels issued, the on-hand
(Quantity)

inventory will last for approximately

weeks.

Order Processing
(to be completed by HUD or HUD’s monitoring agent)

Date request received

.

The request for certification labels was placed with the label manufacturer

(mm/dd/yyyy)

by

on

in the quantity of

certification labels.

(mm/dd/yyyy)

Note: If the quantity ordered is different than requested, the change was authorized by

.
(name)

This order should be received within the next three weeks.

Confirmation of Receipt
(to be completed by IPIA)

We have received the quantity of certification labels authorized by HUD or HUD’s monitoring agent.

Yes

No

If No, contact HUD or HUD’s monitoring agent immediately.
This order was received on

and contained:
(mm/dd/yyyy)

Certification labels

-

through & including

-

=

(Quantity)

These labels were entered into this agency’s on-hand inventory on
(mm/dd/yyyy)

by IPIA authorized label administrator
(signature)

Previous editions obsolete

Form HUD-101 (09/16)