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OMB No. 0596-0220 <br />Secure Rural Schools and Community Self -Determination Act of 2000 <br />Certification of Title III expenditures by participating county <br />The Secure Rural Schools and Community Self -Determination Act of 2000 (the Act), reauthorized in <br />Public Law 117-58 and Public Law 117-102, requires the appropriate official of a county that receives <br />funds under Title III of the Act to submit to the Secretary concerned (the Secretary of Agriculture, or the <br />Secretary of the Interior, as appropriate) an annual certification that the funds expended have been used <br />for the uses authorized under section 302(a) of the Act. The Secretary concerned also is requiring the <br />appropriate official to certify the amount of Title III funds received since October 2008 that have not been <br />spent/obligated. <br />The appropriate official of each participating county may use this form (see page 2) to report information <br />to meet the requirements of the Act. Certification must be made by February 1 following each year <br />Title III funds are being held or spent/obligated by the county. Certain counties in Oregon receive <br />Title III payments initiated by both the Department of Agriculture and the Department of the Interior. If <br />the county received Secure Rural Schools Act Title III payments from more than one agency, the county <br />must certify separately to each Secretary regarding the separate payment initiated by that agency. Submit <br />the certification to the appropriate address below for the respective agency. <br />All counties expending Title III funds received from Forest Service payments are to submit the annual <br />certification by one of the following methods: <br />E-Mail (Preferred) <br />Mail <br />FAX: <br />SM.FS.asc asr(g)usda- ov U.S. Forest Service 877-684-1422 <br />Albuquerque Service Center, B&F ATTN: ASR <br />Attn: Funds Control/ASR <br />4000 Masthead St. NE <br />Albuquerque, NM 87109 <br />Certain counties in western Oregon expending Title III funds received from payments from the <br />Department of Interior for lands administered by the Bureau of Land Management are to submit a <br />separate annual certification about the separate Title III funds by one of the following methods: <br />E-mail: <br />b!m orwa public_roorn0-blm.aov <br />Mail <br />BLM Oregon State Office (OR931) <br />Attn: Title III Coordinator <br />1220 SW 3rd Ave. <br />Portland, Oregon 97204 <br />FAX: <br />503-808-6021 <br />Secure Rural Schools Act <br />Certification of Title III expenditures by participating county <br />Page 1 of 3 <br />