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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: 7/16/2021 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. lf 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. #65 Littleton Elementary Edulink Systems Inc = $7,310.25 RECEIVED 2021 JUL 19 MARICOPA COUNTY CLERK BOARD, a SUPERVISORS AE. (vou 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 Instruction sheet which is page 2 of this form. COUNTY OF MARICOPA EDULINK SYSTEMS INC (1), being first sworn, upon oath deposes and says: On or about 3/ I] / AOA (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 sym of $ 7,310.25 (3) DPiud k L Signed: (4) 2.5 Tine (5) Subscribed and sworn to before me this_ day of 202/. NOTARY PUBLIC JENNA MARIE GRAU —_ ; A 4 otary Public - Californi commission expires: te FS) nan? cony yy <s, ZOZS C= & com ‘ommission # 2356404 oH iron" My Comm. Expires May 3, 2025 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 Fran Number fe 3700405947 mewn) (6) Is: aero Original rigina Date of 03/11/2021 ate of oe - 0 Reason for original issue of Warrant/Check (8): CO Payroll Parent notification service For Services or Goods furnished O Other: Parent notification service 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 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California County of CO BMG E— Subscribed and sworn to (or affirmed) before me on this Z5 day of I] UM 202), by VoevBl Le. Une DUCK ee proved to me on the basis of satisfactory evidence to be the person($q who appeared before me. Orange Coun Commission # 2356404 (Zari f— domm. Expires May 3, 2025 Signature wa (2) Edulink Date: June 25, 2021 Dear Mary, This letter confirms that |, David Funderburk is an authorized signer on our business account. Regards, David Funderburk President