HUD-309 HUD Manufactured Home INstallation Certification and Ver

HUD Manufactured Home
Installation Certification
And Verification Report

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

OMB Approval No.2502-0578
expires 01/31/2015

The Manufactured Housing Installation Program Regulations 24 CFR Chapter XX Part 3286 Sections 111 and 411require the licensed installer certify that the
manufactured home has been installed and inspected in accordance with the regulations. The Manufactured Housing Installation Program Regulations 24 CFR
Chapter XX Part 3286 Subpart F requires a qualified inspector verify that the manufactured home has been installed in accordance with the requirements of Part
3286 and Part 3285. The information collected here will ensure that the licensed installers and qualified inspectors inspect the minimum elements for compliance.
The public record burden for the collection of information is estimated to average 3.5 hours per response including the time to review instructions, search existing
data sources, gather and maintain the data needed, and complete and review the collected information. Response to this information 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.

Certification Label Number(s)

Manufacturer’s Serial Number(s)

(include all zeros and agency prefix)

(include all letters and numbers)

_________________________________________
(Installer Name)
_____________________________________________________
(Homeowner Name)

_____________________________________
(HUD License No.)

_________________
(State)

_____________________________________________________
(Inspector Name)

_________________
(State)

_________________________________________________________________________________
(Street Address)
(City)
(Zip)

_____________________________________________________
(Steer Address)

____________________
(Phone)

1. Initial Inspection
Inspection Item
Site location with respect to home design and construction
Consideration of site specific conditions
24 CFR 3285 Subpart C - Site preparation and grading for
drainage
24 CFR 3285 Subpart D - Foundation construction
24 CFR 3285 Subpart E - Anchorage
24 CFR 3285 Subpart F - Optional features (Skirting, etc.)
24 CFR 3285 Subpart G - Completion of ductwork, plumbing,
and fuel supply systems
24 CFR 3285 Subpart H - Completion of electrical systems
24 CFR 3285 Subpart I - Exterior and interior close-up
Completion of operational checks and adjustments

Inspector Verification

Installer Certification

□ Pass
□ Pass

□ Fail
□ Fail

□ N/A
□ N/A

□ Pass
□ Pass

□ Fail
□ Fail

□ N/A
□ N/A

□ Pass

□ Fail

□ N/A

□ Pass

□ Fail

□ N/A

□ Pass
□ Pass
□ Pass

□ Fail
□ Fail
□ Fail

□ N/A
□ N/A
□ N/A

□ Pass
□ Pass
□ Pass

□ Fail
□ Fail
□ Fail

□ N/A
□ N/A
□ N/A

□ Pass

□ Fail

□ N/A

□ Pass

□ Fail

□ N/A

□ Pass

□ Fail

□ N/A

□ Pass

□ Fail

□ N/A

□ Pass
□ Pass

□ Fail
□ Fail

□ N/A
□ N/A

□ Pass
□ Pass

□ Fail
□ Fail

□ N/A
□ N/A

2. Reinspection of Home (To be completed and initialed by the inspector)
If the inspector discovers that any item during the Initial Inspection fails to comply with the manufacturer’s installation instructions or with an installation
design and instructions that have been certified by a professional engineer or registered architect, the installation must be reinspected after the
installation is corrected.
Describe the work performed following the initial inspection and if the reinspected item(s) are in compliance. Attach additional sheet(s) if necessary.

___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________

3. Inspector Verification
I hereby certify, in accordance with 24 CFR § 3286.507, that the manufactured home identified above has been installed in accordance with an
installation design and instructions that have been provided by the manufacturer and approved by the DAPIA or an installation design and instructions
that have been prepared and certified by a professional engineer or registered architect that have been approved by the manufacturer and the DAPIA as
providing a level of protection for residents of the home that equals or exceeds the protection provided by the federal installation standards in part 3285
of this chapter. It is a crime to knowingly make false statements and/or certifications in any matter within the jurisdiction of the United States such as the
certification on this or any similar form. Penalties upon conviction can include a fine and imprisonment. See 18 U.S. Code Section 1001.
_________________ __________________________ __
Inspector Signature

_________________ ___________
(Date)

4. Installer Certification
I hereby certify, in accordance with 24 CFR §§ 3286.111 and 3286.411, that the manufactured home identified above has been installed in accordance
with an installation design and instructions that have been provided by the manufacturer and approved by the DAPIA or an installation design and
instructions that have been prepared and certified by a professional engineer or registered architect that have been approved by the manufacturer and
the DAPIA as providing a level of protection for residents of the home that equals or exceeds the protection provided by the federal installation standards
in part 3285 of this chapter. It is a crime to knowingly make false statements and/or certifications in any matter within the jurisdiction of the United States
such as the certification on this or any similar form. Penalties upon conviction can include a fine and imprisonment. See 18 U.S. Code Section 1001.

_________________ _____________________________
Installer Signature

Distribution:
Installer
Retailer
Purchaser

_________________ ___________
(Date)
Form HUD - 309