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Refunds Due Manufacturer

U.S. Department of Housing and Urban Development

OMB Approval No. 2502-0233

Office of Manufactured Housing Programs

expires 04/30/2016

(Unused Labels)

The Manufactured Housing Procedural and Enf o rcement Regulations 24 CFR Part 3282 Section 501 authorizes the Secretary to take such actions to oversee

the system as the Secretary deemsappropriate. 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, gather ing and maintaining the data needed, and completing and reviewing the

collection of information. Response to this information collection is mandator y 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 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 facility, advise HUD’ s contracting 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)

T otal Labels Returned: ________________ x $39.00 = $_________________

The above designated certification labels are being returned because:

The facility has been closed eff e ctive:_____________________

(mm/dd/yyyy)

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

(mm/dd/yyyy)

Other: ______________________________________________________________________________

IPIA Verification of Credit Due Manufacturer

(to be completed by IPIA)

The above designated manufactured home certification labels were received by our office on ____________________ .

(mm/dd/yyyy)

This report and the labels have been analyzed and found to be accurate.

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 contracting agent)

Date received ____________________ Received and forwarded to HUD Date: ______________ by _______________

(mm/dd/yyyy)

Distribution

Original - HUD’s Contracting Agent

Copies to: IPIA

Manufacturer

Previous editions obsolete

Form HUD-303 (06/09)

Form Hud-303 - Refunds Due Manufacturer - U.s. Department Of Housing And Urban Development

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