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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre . SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 1/11/2021 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda Vv The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. Vv The original warrant(s) have had a stop payment done. If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor) Thank you. #60 Higley Unified ' James L Bowers $431.14 H Bee ad } j JAN 12 2091 ; MARICOPA COUN CLERK BOARD OF SUPERVISORS Schools Affidavit/Claim Form Application for a Duplicate Warrant/ Check (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNTY OF MARICOPA Instruction sheet which is page 2 of this form. dames L. Bower is (1), being first sworn, upon oath deposes and says: Name/Claimant 242 On or about IQ} Lee aA0dBO (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, or 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 warrant/che¢k be issued to him/her in the sum of $ +3 | )4 (3) bw Signed; C eee (4) Ne and sworn to before me this U+h day of dinuar 202 . Daate ula Natt PAULA WOLTER | ROTARY PUBIC Notary Public - Arizona MARICOPA COUNTY 3 My commission expires: exon dye it 22 INfo/ oH (seal) Note. Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number aD A + . 3 100 3 BS 557 (if known) (6) | Original Date of Issue by / | A? go / re QF / RU (if known) (7) Reason for original issue of Warrant/Check (8): 2024 Payroll Guenste ( ) 1 For Services or Goods furnished [1 Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999