STAMPED AND REDACTED - 3700972649 - MARIA TUCK.PDF

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Schools Affidavit/Claim Forin 
Application for a Duplicate Warrant/Check (doflnlllons are on page 2)
STATE OF ARIZONA 
Nole: Numbers on this form correspond to numbers on the 
COUNTY OF MARICOPA 
Instruction sheet which Is page 2 of this form. 
_Ml(Ja;;;;ri
00a,,.T,.u1mck=r _______ ,(l), being first sworn, upon oath deposes and says: 
Name/Claimant 
On or about May 29, 2026 
(date)(2) a warrant/check was Issued to the 
above named person/entity In the amount as stated below. 
Such warrant/check was 
either never received or was subsequently Inadvertently lost or destroyed and there is 
no reasonable probability of Its being found or presented for payment, ID: it was not 
presented for payment within one year after the date of Issuance. 
Therefore, under penalty of perjury, claimant hereby affirms that this claim Is correct 
and the amount shown Is due and owing, and the applicant requests that a replacement 
(5) Subscribed and sworn to before me this 
/ / th day of J Un.t,
My commission explrey: 
Moy..!9,;!026-
QL-\ / 11 
31) 
r 
• 
AMBER BROWN 
1 
Notary Public - State of Oklahom• 
Commlulon Number 18003687 
My Commlnlon E•plros Apr 11, 2030 
) 
Note: Please attach a copy of the warrant/check if available and/or any other 
evidence that a warrant/check was orlginally issued 
Warrant/Check Number 
3700972649/90584056
/If known) (6\ 
Original Date of Issue 
5/29/2026 
/If known) /7l 
Reason for original Issue of Warrant/Check (8): 
Iii Payroll 
□For Services or Goods furnished, _____________ _
□Other: ____________________ _