HUD-307 HUD Manufactured Home Installer License Application

HUD Manufactured Home
Installer License Application

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

OMB Approval No. 2502-0578
Expires 07/31/2022

The Manufactured Housing Installation Program Regulations 24 CFR Chapter XX Part 3286 Section 207 requires that HUD-licensed installers apply for
an initial or renewed installation license by submitting certain information as required by the Regulations. The information collected here will be used to
evaluate applicants and issue or deny licensure based on the information provided. Public reporting burden for this collection is estimated to average 2.0
hours per response including the time for reviewing the instructions, gathering and maintaining the data as needed, and completing and reviewing the c
ollection of information. Response to the information collection is required obtaining and retaining installer license. 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.

Date of Application
(mm/dd/yyyy)

If renewal, provide HUD-license number and expiration date

Application (please check one):
Initial License Application

License Renewal Application

Section 1 - Applicant Personal Information
To be completed by all applicants

Legal Name of Applicant (Last, First, Middle Initial)

Applicant Date of Birth (mm/dd/yyyy)

Street Address (P.O. Box is not acceptable)

City

Business Phone Number with area code

Home Phone Number with area code

State

Zip Code

Email Address

Section 2 - Applicant Business Information
To be completed by all applicants
Name of Business Affiliation

Street Address (P.O. Box is not acceptable)

City

State

Zip Code

Business Phone Number with area code (###.###.####)

Section 3 - Required Training for Initial License or Continuing Education for License Renewal
To be completed by all applicants (use additional sheets as necessa
Name of HUD-Registered Trainer or
Provider of Continuing Education

Distribution:
HUD

Brief Description of course content

Page 1 of 2

Date of Training
or Continuing
Education

Hours Completed
(attach completion
certificates for all courses)

Form HUD-307

Section 4 - Successful Completion of HUD-administered or HUD-approved Installer Test
To be completed by applicants for initial license onl
Date of Test
Test Administrator
(mm/dd/yyyy)

Test Location
(City, State)

Test Score
(attach copy of test score record)

Section 5 - Proof of Surety Bond or Insurance
To be completed by all applicants
Name of Insured Person/Company
Insurance Carrier

Policy/Binder Number

Amount Covered

Policy Expiration Date
(mm/dd/yyyy)

Section 6 - Required Experience
To be completed by all applicants
If the applicant retains State certification(s) or license(s) to perform installation work in a State with a qualifying program, please check here to
request a waiver for proof of experience requirements and provide a copy of the current State certification(s) or license(s).

Waiver Requested (proceed to Section 7))
Areas of Experience (check all that apply)

1,800 hours of manufactured home installation

3,600 hours of manufactured home construction

1 year of college education per §3286.205

3,600 hours of building construction supervision

Combination totalling 3,600 hours

Verification of Required Experience (please check one)

By checking this box, I self certify that my experience meets the minimum requirements indicated above.
I am attaching statements of experience verification by past and/or present employers demonstrating experience in the areas indicated above.

Section 7 - Other Installation Certifications or Licenses
To be completed by all applicants (please check one)

I DO NOT retain State certification or license to perform installation work (Proceed to Section
I DO retain State certification(s) or license(s) to perform installation work (Complete information in the following
State Certification/License Information (use additional sheets as necessary)
State of
License/Certification
Current or Expired
Suspended, Revoked or Denied
Issuance Number
(check one box)
(check yes or no)

Explanation if Suspended, Revoked, or Denied

Current

Expired

Yes (Provide explanation)

No

Current

Expired

Yes (Provide explanation)

No

Current

Expired

Yes (Provide explanation)

No

Section 8 - Certification of Information Provided in Application
By signing, I certify that the information provided in this application and any accompanying documentation is true, complete, accurate, and current as of the _______ day
of
(month), ________ (year). I understand any license issued for this application is not transferable and is subject to suspension or revocation in accordance with the
regulation in 24 CFR part 3286. I agree to submit any changes affecting sections 1, 2, or 5 of t his application to HUD within 30 days of a change. I acknowledge that making,
presenting, or submitting a false, fictitious, or fraudulent statement, representation, or certification may result in criminal, civil, and/or administrative sanctions,
including fines, penalties, and imprisonment.________________________________________________________________________________________________
Applicant Signature
Print Name

Distribution:
HUD

Page 2 of 2

Form HUD-307