STAMPED & REDACTED JAMES FARNSWORTH.PDF

INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 7/8/2021
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.
#401 EVIT James Farnsworth $100.00
RECEIVED
2021
JUL 99 ING
MARICOPA COUNTY
SUPERVISORS M
CLERK BOARD OF

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.
Jones Vac nowol th (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about _ |\O/7 13 /2.92.0 (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
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warrant/check be issued to him/her in $ (3)
ye
signes: <a. ll
arn
sworn to séfore me this is 22 ay of “9 2/,
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LM tax.
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NOTARY PUBLIC
( TAMMY NORRIS }
My co expires: rn) Notary Maricopa Public Coun! - Arizona
feos] PO a 2 My ean Expies Jan, Fe 008 ) (seal)
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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 - “7 tA JILL er
37100 355 l5 Y /AOWYE S27
(if known) (6)
Original Date of Issue fase J
OT114 (2020
(if known) (7)
Reason for original issue of Warrant/Check (8):
1 Payroll
OC For Services or Goods furnished 07/13/2021
7
W Other: Saves Act o2020
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

7/8/2021 East Valley Institute of Technology Mail - Cares act check
Melissa Garcia
CAHEER AGH CZILLECHE PREM
Cares act check
1 message
Thu, Jul 8, 2021 at 10:14 AM
James Farnsworth
To:
Melissa name is James Farnsworth and | never received my cares act check. The check number is 3700335258. Thank
Hey my
you in advance!
Sent from my iPhone
704737600814292148&simpl=msg-f%3A17047376008... 1/1
https://mail.google.com/mail/u/0?ik=021 c246bce&view=pt&search=all&permthid=thread-f%3A1

Office of the Maricopa County
School Superintendent
Warrant Void/Stop Request
District Name / Number: East Valley Institute of Technology 401
Attachments:
Contact Name: Brittany Brewer [| Original Warrant
Contact e-mail: Lost Warrant Affidavit (required for ALL reissues)
[| Vendor Letter (if requesting Vendor reissue)
Date Wearrant Number Warrant Date | Amount Payee
{starting with “37") {mm/dd/yyyy) (as it appears in Check Manager) Void Stop
3700335258) 7/14/2020 | $ 100.00 James Farnsworth QO
Amount
Notes: Check was lost, please reisse with address 510 S. Extension Rd Apt 1086 Mesa, AZ 85210
4
ay 4 ‘
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District Approver: Fadl lo Date: a3 Pa
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#
VY
WT Fer Internal Use Onh
Clerk of Board Date: Void Report Date:
Reissue

3700339298 |
SCHOOL EXPENSE WARRANT Wy
— vhciity, Az
TREASURER OF MARICOPA COUNTY.» i. ig
nize
PHOENIX, ARIZONA : DATE CONTROL NO. s
DATE MARKED “INSUFFICHENT FONDS”
ITT REGGE SIGRS Ob DATE FUNDS AVAR ALLE (SEG 14-535, ARS VUSD} 2
07/14/2020 = 401648327
East Valley Institute of Technology District #401 7
WARRANT AMOUNT a
PAY zs
**One Hundred and 00/100"**" Dollars $100.00 3
Q
VOID AFTER 365 DAYS
|
yO James Farnsworth AG \ :
: g
ORDER
Superintendent ot Sdilonizeo
mene SIGNATURES
07/14/2020 Check: 401648327 = EXPENSE
MARICOPA COUNTY SCHOOLS + PHOENIX, ARIZONA
AP 20200715 3700335258
. .
James Farnsworth | | 07/14/2020 |
| | Check Date |
Payee
we
Account Number PO Number Invoice Amount
~~ Rt1E4 CARES ACT 2020 400 06
VOUCHER: 1002 TOTAL: $100.00
HARLAND CLARKE Mévexe 90325231