ASR ELECTION_ARIZONA MARICOPA COUNTY_SIGNED.PDF
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County Name Estimated SRS Payment Estimated 1908/25% Payment Payment Election: SRS or 1908/25% Payment Percent for Public Schools & Roads (Title I) Percent for Special Projects (Title II) Percent for County Funds III) Percent to Return to U.S. Treasury Percent Total Election to Receive Payment State: Title Allocation of the Secure Rural School Act Payment Percentage (number) in the columns below, not to exceed 100 total County Name Estimated SRS Payment Estimated 1908/25% Payment Payment Election: 1908/25% Payment for Public Schools & Roads (Title I) for Title II, Special Projects for Title III, County Funds Return to U.S. Treasury Total State: Election to Receive Payment Title Allocation of the Secure Rural School Act Payment Percentage (number) in the columns below, not to exceed 100 total **Required Contact Information** Preparer’s name and title: Preparer’s phone number: Preparer Signature: Preparer’s email: Michael McGee