STAMPED & REDACTED JULIE SCHNEPP 1.PDF

INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits - Replacement of Lost Warrants
DATE: 7/15/2021
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 r may be routed back to the Superintendent
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor)
Thank you.
#79 Litchfield Elementary Julie Schnepp $136.51
#79 Litchfield Elementary Julie Schnepp $77.25

Schools Affidavit/Claim Form
Application for a Duplicate Warrant/Check (definitions are on page 2)
STATE OF ARIZONA PR Note: Numbers on this form correspond to numbers on the
COUNTY OF MARIGOPA EVe| Instruction sheet which is page 2 of this form.
Ne Sant (1), being first sworn, upon oath deposes and says:
On or about 06/01/21 (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/check be issued to him/her in the sum of g¢ 17.25 (3)
ae
Signed: Ag (4)
Me
and to this SX ‘ian aay of NUN 20n1.
(5) ao
yp 9
NOTARY PUBLIC Commonwealth of Pennsylvania - Notary Seal
Deborah Kernohan, Notary Public
Erie County
My ission expires: . My commission expires September 4, 2024
AaTbu load Commission number 1377559 (seal)
t T Member, Pennsylvania Association of Notaries
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 |9709(9430105/79740859
(if known) (6) a —* ed
ra Seyele 06/0 L 1202
(if known) (7)
Reason for original issue of Warrant/Check (8):
O Payroll
07/16/2021
fj For Services or Goods furnished
OO 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

MARICOPA COUNTY SCHOOL SUPERINTENDENT
301 W. JEFFERSON, SUITE 660
PHOENIX, AZ 85003
TO: PAYROLL —- ACCOUNTS PAYABLE
PLEASE STOP PAYMENT AND REISSUE THE FOLLOWING WARRANT:
O77]
DISTRICT NUMBER:
|
OP EANMIENT Man Ya Fer) be. PHONE#: EXT:
37-0043 0/0S__ WARRANT DATE: by) of 1 Al
WARRANT NUMBER:
(prefix) (number) (mm) (dd) (yy)
Sch Tu he
PAYABLE TO: 7} CYP j
¢£ 77: IE
AMOUNT:
5S3/
FUND NO: 20 / VOUCHER NO:
|
CHECK ONE: EXPENSE PAYROLL
x
—_ —_
REASON FOR STOP: r |
(heck 4067 1A MAI — flayce CElssge
»——f. rn jf - ——— : —s £
=e pA =
(LOST, DESTROYED, ETC.)
ONE ORIGINAL AFFIDAVIT AND ONE COPY OF THE AFFIDAVIT ARE ATTACHED. PLEASE
ISSUE A REPLACEMENT WARRANT.
(FOR COUNTY USE ONLY)
STATUS VERIFIED:
STOP DATE: REPLACED:
STOP VERIFIED: WARRANT #:
AFFIDAVIT SENT:
AFFIDAVIT APPROVED:
RECONS RETURNED: STOP PREPAID
H:\Work\LOST WARRANT STOP-REISSUE COVER SHEET.Doc