Manufactured Housing Complaint Form - Maine Department Of Professional And Financial Regulation Page 2
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1
2
3Manufactured Housing Board
Complaints and Investigations Division
Office Located at:
35 State House Station
76 Northern Avenue
Augusta Maine 04333
Gardiner ME
(207) 624-8612
M A N U F A C T U R E D H O U S I N G C O M P L A I N T F O R M
Name ____________________________________________________________________________________
Address___________________________________________________________________________________
(Street)
_________________________________________________________________________________________
(City or Town)
(State/Zip Code)
(County)
E-Mail
___________________________________________________________________________________________________________
Home Telephone (
) ___________________ Day Time Telephone (
) ____________________
Cell Telephone (
) ___________________
Type of Unit: Mobile ___ or Modular ___
*All Labels are primarily located under the kitchen sink cabinet or master bedroom closet
State Certification Label Number (Modular Only) ___________________________
Maine Warranty Label Number (Modular and Mobile) _______________________
Installation Warranty Label Number (Modular and Mobile) ____________________
Manufacturer/Location________________________________________________________________________
Dealer/Location_____________________________________________________________________________
Installer/Location____________________________________________________________________________
Date of Manufacture___________________ Model #_________________ Serial #______________________
Date of Installation ____________________
Transfer of Ownership/Closing Date________________________
Has the manufacturer and/or dealer been contacted? ______ If so, how?________________________________
If so, list dates _______________________________________________________________________________
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