Relocation Assistance Claim - Arizona

RELOCATION ASSISTANCE CLAIM — ARIZONA

SUBMITTED TO THE DISPLACING AGENCY — NOT A COURT PLEADING

I. INTRODUCTION AND STATUTORY BASIS

This is a formal claim for relocation assistance benefits submitted by [CLAIMANT NAME] ("Claimant"), a displaced person within the meaning of A.R.S. § 11-961(4), in connection with the acquisition of the above property by [DISPLACING AGENCY] ("Agency") for the [PROJECT].

This claim is made under the Arizona relocation assistance statute, A.R.S. § 11-961 et seq. Because the Project [☐ is / ☐ is not] funded in whole or part with federal financial assistance, this claim is also made under the federal Uniform Relocation Assistance Act, 42 U.S.C. § 4601 et seq. (including §§ 4622–4625), and 49 C.F.R. Part 24. Where state and federal benefit levels differ, Claimant claims the higher applicable amount.

Relocation benefits are separate from, and in addition to, just compensation for the property acquired. This claim does not waive, reduce, or duplicate any claim for just compensation under Ariz. Const. art. 2, § 17 and A.R.S. Title 12, Ch. 8.

II. CLAIMANT AND DISPLACEMENT DETAILS

Claimant category (select one or more):

☐ Residential owner-occupant — A.R.S. § 11-964 (replacement housing for homeowners)
☐ Residential tenant / 90-day occupant — A.R.S. § 11-965 (replacement housing for tenants and others)
☐ Business — A.R.S. §§ 11-961(2), 11-963; 49 C.F.R. § 24.304
☐ Farm operation — A.R.S. §§ 11-961(6), 11-963; 49 C.F.R. § 24.304
☐ Nonprofit organization — A.R.S. § 11-963; 49 C.F.R. § 24.304

III. ELIGIBILITY

Claimant certifies eligibility as a "displaced person" under A.R.S. § 11-961(4) and, where applicable, 49 C.F.R. § 24.2(a):

☐ Claimant moved (or will move) from the property as a direct result of a written notice of intent to acquire, initiation of negotiations, or acquisition for the Project.
☐ Claimant is lawfully present in the United States (49 C.F.R. § 24.208).
☐ Claimant is not an unlawful occupant and did not occupy solely to obtain assistance (A.R.S. § 11-961(4)).
☐ Owner-occupant claims: Claimant owned and occupied for the required period; any mortgage-interest differential requires a bona fide mortgage that was a valid lien for at least 180 days before initiation of negotiations (A.R.S. § 11-964(A)(2)).
☐ Tenant claims: Claimant lawfully occupied for not less than 90 days before initiation of negotiations.

IV. ITEMIZED BENEFITS CLAIMED

(a) Moving and Related Expenses — A.R.S. § 11-963; 49 C.F.R. §§ 24.301–24.305

Method (residential): ☐ Actual reasonable expenses (documented) ☐ Moving expense and dislocation allowance (per lead-agency schedule, A.R.S. § 11-963(B); 49 C.F.R. § 24.302)

(b) Replacement-Housing Payment / Rental Assistance / Down-Payment

Owner-occupant — A.R.S. § 11-964 (federal 90-day cap $41,200, 49 C.F.R. § 24.401)

Must purchase and occupy a comparable replacement dwelling within one year of final payment or satisfaction of the Agency's § 11-971 obligation, whichever is later (A.R.S. § 11-964(B)). Federal cap: ☐ $41,200 ☐ Last-resort amount under 49 C.F.R. § 24.404.

Tenant / 90-day occupant — A.R.S. § 11-965 (federal cap $9,570, 49 C.F.R. § 24.402)

(c) Business / Farm Reestablishment + Fixed Payment In Lieu

(d) Incidental / Closing Costs

(e) Advisory Services — A.R.S. § 11-962; 42 U.S.C. § 4625; 49 C.F.R. § 24.205

☐ I was offered advisory assistance and information on comparable replacement dwellings/sites (§ 11-962(C)).
☐ I was informed of federal, state, and local assistance programs and my relocation rights.
☐ I was NOT provided required advisory services (explain): [________________________________]

Supporting-Documentation Checklist (attach all that apply)

☐ Copy of notice of displacement / eligibility / written offer
☐ Proof of occupancy and dates (lease, deed, utility bills, tax records)
☐ Moving estimates (2 recommended) and/or paid invoices and receipts
☐ Settlement statement / closing disclosure for replacement dwelling
☐ Mortgage documents (acquired and replacement dwellings)
☐ Comparable replacement dwelling/site referrals from the Agency
☐ Business: 3–5 years of tax returns and profit-and-loss statements (fixed in-lieu basis)
☐ Itemized inventory and photographs of personal property moved
☐ Receipts for reestablishment / search expenses
☐ Other: [________________________________]

TOTAL RELOCATION ASSISTANCE CLAIMED

TOTAL CLAIM: $[____________]

V. STATUTORY BASIS AND CAPS (STATE + FEDERAL)

1. Moving expenses. A.R.S. § 11-963 entitles a displaced person to actual reasonable moving and related expenses, or a schedule allowance; search up to $2,500 and reestablishment up to $25,000 (state). For federally funded projects, 49 C.F.R. §§ 24.301–24.305 raise search to $5,000 and reestablishment to $33,200.
2. Fixed in-lieu payment. A.R.S. § 11-963(C) allows a business/farm to elect a fixed payment of $1,000 to $40,000 (state); the federal ceiling (49 C.F.R. § 24.305) is $53,200.
3. Owner replacement housing. A.R.S. § 11-964 provides the price differential, mortgage-interest differential (180-day lien), and incidental costs; the federal cap (49 C.F.R. § 24.401) is $41,200 (90-day occupant); purchase/occupy within one year.
4. Tenant assistance. A.R.S. § 11-965 provides rental assistance or down-payment; the federal cap (49 C.F.R. § 24.402) is $9,570.
5. Housing of last resort. Where comparable replacement housing cannot be obtained within the caps, additional payments are made under 49 C.F.R. § 24.404.
6. Claim period. File within 18 months of the later of the move or final acquisition payment. 49 C.F.R. § 24.207(d).

VI. DEMAND FOR DETERMINATION AND PAYMENT

Claimant demands that the Agency:

1. Determine eligibility and approve and pay the benefits itemized in Section IV, totaling $[____________]; and
2. Within [____] days of the date of this claim (and no later than [__/__/____]), provide a written determination stating the amount approved for each category and, for any denial or reduction, the specific reasons and applicable authority.

If the Agency fails to issue a timely written determination, Claimant will treat the claim as denied for purposes of pursuing the appeal described below.

VII. RESERVATION OF RIGHTS AND APPEAL

1. Relocation benefits are in addition to just compensation. This claim does not waive or reduce Claimant's right to just compensation for the property taken (Ariz. Const. art. 2, § 17; A.R.S. Title 12, Ch. 8) and may not be offset against or duplicated by that amount.

2. Administrative appeal. If this claim is denied or reduced, Claimant has the right to appeal through the Agency's relocation grievance procedure and, for federally funded projects, under 49 C.F.R. § 24.10. Claimant may:
   ☐ Request a written explanation of the determination;
   ☐ File a written appeal with the Agency within the time the Agency allows;
   ☐ Obtain review by an official not involved in the original determination, present evidence, and be represented by counsel;
   ☐ Seek judicial review (special action / A.R.S. Title 12) if the administrative appeal is denied.

3. Claimant reserves the right to amend or supplement this claim as additional expenses are incurred or documentation becomes available.

VIII. CERTIFICATION AND SIGNATURE

I certify under penalty of perjury that the foregoing is true and correct and that the expenses claimed were actually incurred, or will be incurred, in connection with my displacement from the identified property.

Claimant Signature: [________________________________]

Printed Name: [________________________________]

Date: [__/__/____]

Prepared by / Representative (if any):

[________________________________]
☐ Attorney for Claimant — State Bar of Arizona No. [__________]
[FIRM NAME] · [ADDRESS] · Tel: [__________] · Email: [__________]

IX. ARIZONA PRACTICE NOTES

• Comprehensive state act. A.R.S. § 11-961 et seq. is Arizona's relocation assistance scheme, modeled on the federal URA. It defines "acquiring agency" broadly to include any entity with the power of eminent domain (§ 11-961(1)) and assigns schedule- and criteria-setting to the "lead agency."
• ADOT. For highway and federally funded transportation projects, the Arizona Department of Transportation Right-of-Way Relocation Section administers benefits under both the state act and 49 C.F.R. Part 24, following the FHWA "Your Rights and Benefits as a Displaced Person" framework.
• State caps lower than federal. The state statute fixes search ($2,500), reestablishment ($25,000), and fixed in-lieu ($1,000–$40,000) amounts that are below the current federal figures ($5,000 / $33,200 / $53,200). On federally funded projects the higher federal amounts apply.
• Owner mortgage-interest differential requires a bona fide mortgage that was a valid lien for at least 180 days before initiation of negotiations (§ 11-964(A)(2)); the replacement dwelling must be purchased and occupied within one year.
• No double recovery. Relocation payments are not just compensation for the property and must not be duplicated; keep the claims separate.
• Deadline. File within 18 months; confirm the Agency's specific deadline and appeal window.

X. SOURCES AND REFERENCES

• A.R.S. § 11-961 (definitions) — https://www.azleg.gov/ars/11/00961.htm
• A.R.S. § 11-962 (advisory services) — https://codes.findlaw.com/az/title-11-counties/az-rev-st-sect-11-962/
• A.R.S. § 11-963 (moving/reestablishment; fixed in-lieu) — https://www.azleg.gov/ars/11/00963.htm
• A.R.S. § 11-964 (replacement housing for homeowners) — https://www.azleg.gov/ars/11/00964.htm
• A.R.S. § 11-965 (replacement housing for tenants and others)
• 42 U.S.C. §§ 4622–4625 (federal URA) — https://uscode.house.gov/
• 49 C.F.R. Part 24 (federal URA regulations; §§ 24.301, 24.304, 24.305, 24.401, 24.402, 24.404, 24.10) — https://www.ecfr.gov/current/title-49/subtitle-A/part-24
• ADOT Right-of-Way Booklets and Manuals — https://azdot.gov/business/right-way-properties/booklets-and-manuals-right-way-properties
• 2024 URA rule (cap increases) — https://www.federalregister.gov/documents/2024/05/03/2024-08736/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. Relocation benefits, caps, and deadlines vary by funding source and are governed by both Arizona law and the federal Uniform Relocation Act. An attorney licensed in Arizona should review and customize this claim before filing. Verify all citations and current benefit amounts before relying on them.