ARIZONA COMBINED INSTRUCTIONS AND ELECTION FORM, MARICOPA COUNTY.PDF

Forest Service 
Albuquerque Service Center 
101 B Sun Avenue, NE 
Albuquerque, NM 87109 
America’s Working Forests – Caring Every Day in Every Way    
 Page 1 of 3 
FY 2022 Forest Service Payment to States, Public Law 117-58 
Election to Allocate the State Payment
A county’s Election to receive a payment and to allocate the State payment must be 
transmitted by the Governor’s office or other appropriate executive office of the state such as 
State Treasurer, on behalf of the Governor. The Forest Service will not accept an election 
directly from a county or from any non-governmental organization acting on behalf of a county. 
Instructions: 
To begin, refer to Expired Elections and Earnings attachment for FY21 data dealing with earnings 
and expired allocation percentages by title. The allocation percentage values are now expired in 
FY22 but represented amounts that were used to determine last year’s FY21 payment.  These 
figures are being presented to aid States/Counties with historical data as they prepare new 
percentage allocation submissions.  Counties paid in FY21 under the 1908 Amended Act are also 
presented on the report. These counties will remain classified as this designation for the FY22 
payments cycle and no allocation elections for these counties will be accepted. 
The Total FY21 Earnings value on the attachment represent the total dollar value earned by each 
county in FY21.  The FY22 dollar figures will not be available until after the allocation election due 
date, so the FY21 figures represent the best available data in determining which distribution 
allocation guidelines applies.  After determining the FY21 dollar amount and distribution category 
for each county from the attachment, refer to the three options below for further instructions on 
percent allocation limits. 
•
$100,000 or less. (minor distribution) An eligible county that elects to receive a share of the 
State payment that is $100,000 or less (a minor distribution) may elect to use 100-percent of 
its share for public roads and schools under title I (column C).  A county that elects to 
receive a minor distribution must make an affirmative election to use the 100-percent of its 
share for title I purposes.  In the alternative, the county may opt to allocate 15-percent to
20-percent of its share to title II (column D), title III (column F), or a combination of both.  
The total percentage allocated to title II and title III combined must be no less than 15-
percent and no greater than 20-percent.  The county also may opt to return its allocation, in 
whole or part, to the Federal Government.

Forest Service 
Albuquerque Service Center 
101 B Sun Avenue, NE 
Albuquerque, NM 87109 
America’s Working Forests – Caring Every Day in Every Way    
 Page 2 of 3 
•
$100,001 to $349,999 (moderate distribution) If the county share of the State payment is
more than $100,000 but less than $350,000, the county must allocate 15-percent to 20-
percent of its share to title II (column D), title III (column E), or a combination of both. The
total percentage allocated to title II and/or title III must be no less than 15-percent and no
greater than 20-percent.  The county also may opt to return its allocation, in whole or part,
to the Federal Government (column F).
•
$350,000 or greater (major distribution) If the county share of the State payment is
$350,000 or greater, the county must allocate 15-percent to 20-percent of its share to title II
(column D), title III (column E), or a combination of both, except that the allocation for title III
projects may not exceed 7-percent. The total percentage allocated to title II and title III
combined must be no less than 15-percent and no greater than 20-percent.  The county also
may opt to return its allocation, in whole or part, to the Federal Government (column F).
Each county that elected to share in the Secure Rural Schools Act State payment (formula 
payment) must complete this form.  An eligible county that fails to elect to allocate its share of 
the State payment shall be considered to have elected to expend 80-percent of the share for 
public schools and roads. The remaining 20-percent will be available to the Forest Service to 
carry out projects in the eligible county to further the purposes of title II. 
A county electing to return a percentage of its share of the State payment to the U.S. 
Treasury instead of allocating a portion to Title II or Title III should show the percentage to 
be returned to Treasury in Column F. 
Refer to page 3 for county title elections chart. 
Must be returned to USFS by September 30, 2022

Forest Service 
Albuquerque Service Center 
101 B Sun Avenue, NE 
Albuquerque, NM 87109 
America’s Working Forests – Caring Every Day in Every Way    
 Page 3 of 3 
State: __Arizona_________ 
Column G is auto populated from the entries in columns C, D, E, & F 
G total must equal 100 
A 
B 
C 
D 
E 
F 
G 
Entry 
No. 
County Name 
State Payment—Percentage 
allocated to 
Total 
Columns 
C, D, E & F 
(100%) 
Title 
I 
Title 
II 
Title 
III 
Return to 
Treasury 
1 
Apache (001) 
2 
Cochise (003) 
3 
Coconino (005) 
4 
Gila (007) 
5 
Graham (009) 
6 
Greenlee (011) 
7 
Maricopa (013) 
8 
Mohave (015) 
9 
Navajo (017) 
10 
Pima (019) 
11 
Pinal (021) 
12 
Santa Cruz (023) 
13 
Yavapai (025) 
14 
15 
Information below is required 
Preparer’s name and title: 
Preparer’s mailing address: 
Preparer’s phone number: 
Preparer Signature: 
Preparer’s email: 
 
0
0
0
0
0
0
85
8
7
0
100
0
0
0
0
0
0
0
0
Cynthia Goelz
506-6010
Maricopa County 
301 W. Jefferson 
9th Floor 
Phoenix, Arizona 85003
Cindy.Goelz@Maricopa.gov
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