Remember, whenever there is an issue with your manufactured home, always notify the retailer, manufacturer or installer first. You may submit a request for dispute resolution by completing the Manufactured Home Dispute Resolution Form below, but first please share how you heard about the program and whether there is currently another mediation effort underway outside of the Manufactured Home DRP.


How did you hear about the HUD Manufactured Housing DRP?

Is there another mediation effort in progress outside of the Manufactured Home DRP? *




* Indicates a required field

Initial Information


Name of person requesting assistance in resolving dispute*
Role in the dispute: (check one) *

Homeowner
Manufacturer
Retailer
Installer


Other parties involved in this dispute

Homeowner
Manufacturer
Retailer
Installer


Information on the home


Street address of home:*
City*
State*
Zip*

Daytime Phone *

Evening or weekend phone *

E-mail address

Name of manufactured home park, if applicable

   

Serial number of home*

* If you have multiple serial numbers, enter the serial number followed by a comma e.g; serial1,serial2

Model number of home

HUD label number

Date home was purchased

Date home was delivered to the installation site


Date home was installed *

Additional information on person requesting the dispute resolution


Name

Street address

City
State
Zip

Daytime Phone

Evening or weekend phone

E-mail address

Manufacturer of home


(Corporate name if known)

Company name of manufacturer *

Name of manufacturing plant in which home was built

Name of contact person at plant if known

Street Address

City
State
Zip

Telephone

E-mail address

Retailer of home


Name of Retailer *

Street address

City
State
Zip

Telephone

E-mail address

Installer of home


Name of company that installed the home *

Name of person that installed the home

Name of contact person for the installation company

Street address of installer’s company

City
State
Zip

Telephone

E-mail address

Description of Dispute


Description of the dispute *

Have you previously written to the federal Office of Manufactured Housing Programs regarding this or other issues involving this home?

Have you contacted the [manufacturer, retailer or installer] regarding your complaint?

If yes

Person/firm contacted
Date(s) Contacted
by phone, by email, by mail?
 


Attach copies of all written correspondence to or from the manufacturer, retailer, installer, or homeowner. Also, attach copies of any other documentation to support your dispute. These documents will not be returned.







Manufactured Housing Dispute Resolution Information Form OMB Approval No. 2502-0562

Public reporting burden for this collection of information is estimated to average 60 minutes 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. This information is required to obtain benefits. HUD may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number.

42 U.S.C. § 5422(g) (section 623(g) of the National Manufactured Housing Construction and Safety Standards Act of 1974) authorizes HUD to implement a dispute resolution program in each State that does not have a program meeting the requirements of 42 U.S.C. § 5422(c)(12). Your answers to the following questions are necessary for a proper evaluation of your dispute. The respondents are homeowners, installers, retailers, and manufacturers of manufactured housing. HUD does not pledge assurance of confidentiality to respondents. HUD generally discloses this data only in response to a Freedom of Information request.
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