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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: 5/11/2021 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda V 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. #60 Higley Unified Jennifer Kaiser $64.52 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. Jennifer Kaiser (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 99/25/2021 (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 64.52 warrant/check be issued to him/her in the sum of $ (3) Signed: ———-—~ —— (4) 5 1 24 1 1 10 1553 1500 74 47 96.975899 day 5 1 24 1 1 11 1643 1500 42 37 96.301094 of 5 1 24 1 1 12 1730 1463 34 91 32.139248 Vv 5 1 24 1 1 13 1782 1485 70 103 57.698231 Ay 5 1 24 1 1 14 2032 1500 48 37 96.982475 20 5 1 24 1 1 15 2093 1476 104 60 59.646912 21. 2 1 25 0 0 0 1566 1638 403 14 -1 3 1 25 1 0 0 1566 1638 403 14 -1 4 1 25 1 1 0 1566 1638 403 14 -1 5 1 25 1 1 1 1566 1638 403 14 95.000000 2 1 26 0 0 0 1601 1638 368 14 -1 3 1 26 1 0 0 1601 1638 368 14 -1 4 1 26 1 1 0 1601 1638 368 14 -1 5 1 26 1 1 1 1601 1638 368 14 95.000000 2 1 27 0 0 0 399 1638 1570 24 -1 3 1 27 1 0 0 399 1638 1570 24 -1 4 1 27 1 1 0 399 1638 1570 24 -1 5 1 27 1 1 1 399 1638 1570 24 95.000000 2 1 28 0 0 0 1486 1660 662 233 -1 3 1 28 1 0 0 1486 1660 662 233 -1 4 1 28 1 1 0 1552 1660 372 42 -1 5 1 28 1 1 1 1552 1660 157 42 96.138138 PAULA 5 1 28 1 1 2 1722 1660 202 37 95.882851 WOLTER 4 1 28 1 2 0 1486 1709 440 45 -1 5 1 28 1 2 1 1486 1740 3 3 0.000000 , 5 1 28 1 2 2 1550 1715 108 39 54.376545 Notary 5 1 28 1 2 3 1670 1711 100 34 93.284195 Public 5 1 28 1 2 4 1781 1726 11 7 92.564125 - 5 1 28 1 2 5 1801 1709 125 32 92.989639 Arizona 4 1 28 1 3 0 1527 1751 425 45 -1 5 1 28 1 3 1 1527 1756 231 40 96.129501 MARICOPA 5 1 28 1 3 2 1772 1751 180 39 95.867180 COUNTY 4 1 28 1 4 0 1555 1799 368 41 -1 5 1 28 1 4 1 1555 1804 203 36 93.256615 Commission 5 1 28 1 4 2 1769 1802 20 33 93.225662 # 5 1 28 1 4 3 1802 1799 121 35 94.625977 592374 4 1 28 1 5 0 1541 1844 607 49 -1 5 1 28 1 5 1 1541 1851 121 40 96.602997 Expires 5 1 28 1 5 2 1674 1847 132 34 95.461487 October 5 1 28 1 5 3 1818 1845 27 36 65.418594 5, 5 1 28 1 5 4 1860 1844 80 33 96.631027 2024 5 1 28 1 5 5 2053 1853 95 40 96.949112 (seal) 2 1 29 0 0 0 402 1677 352 36 -1 3 1 29 1 0 0 402 1677 352 36 -1 4 1 29 1 1 0 402 1677 352 36 -1 5 1 29 1 1 1 402 1677 179 36 95.916611 NOTARY 5 1 29 1 1 2 599 1677 155 36 96.454460 PUBLIC 2 1 30 0 0 0 1277 1665 228 225 -1 3 1 30 1 0 0 1277 1665 228 225 -1 4 1 30 1 1 0 1277 1665 228 225 -1 5 1 30 1 1 1 1277 1665 228 225 95.000000 2 1 31 0 0 0 402 1793 499 134 -1 3 1 31 1 0 0 402 1793 499 134 -1 4 1 31 1 1 0 402 1793 499 49 -1 5 1 31 1 1 1 402 1793 57 45 93.298309 My 5 1 31 1 1 2 476 1793 245 36 0.000000 conamisgion 5 1 31 1 1 3 740 1793 161 49 96.690376 expires: 4 1 31 1 2 0 479 1812 341 115 -1 5 1 31 1 2 1 479 1812 156 115 58.509720 lofts 5 1 31 1 2 2 654 1842 166 71 0.000000 faz 2 1 32 0 0 0 398 1888 608 7 -1 3 1 32 1 0 0 398 1888 608 7 -1 4 1 32 1 1 0 398 1888 608 7 -1 5 1 32 1 1 1 398 1888 608 7 95.000000 2 1 33 0 0 0 1276 1883 695 22 -1 3 1 33 1 0 0 1276 1883 695 22 -1 4 1 33 1 1 0 1276 1883 695 22 -1 5 1 33 1 1 1 1276 1883 695 22 95.000000 2 1 34 0 0 0 2250 1451 14 502 -1 3 1 34 1 0 0 2250 1451 14 502 -1 4 1 34 1 1 0 2250 1451 14 502 -1 5 1 34 1 1 1 2250 1451 14 502 95.000000 2 1 35 0 0 0 298 1939 1964 17 -1 3 1 35 1 0 0 298 1939 1964 17 -1 4 1 35 1 1 0 298 1939 1964 17 -1 5 1 35 1 1 1 298 1939 1964 17 95.000000 2 1 36 0 0 0 402 2022 1810 107 -1 3 1 36 1 0 0 402 2022 1810 107 -1 4 1 36 1 1 0 402 2022 1810 48 -1 5 1 36 1 1 1 402 2025 132 37 83.491699 Note. 5 1 36 1 1 2 563 2024 136 38 95.286095 Please 5 1 36 1 1 3 726 2024 131 38 96.551872 attach 5 1 36 1 1 4 885 2034 25 27 96.663254 a 5 1 36 1 1 5 939 2034 101 36 96.396286 copy 5 1 36 1 1 6 1064 2023 51 38 95.813705 of 5 1 36 1 1 7 1135 2023 66 38 93.265259 the 5 1 36 1 1 8 1231 2023 304 45 92.658585 warrant/check 5 1 36 1 1 9 1558 2023 37 37 95.646988 if 5 1 36 1 1 10 1612 2022 185 38 95.897453 available 5 1 36 1 1 11 1824 2022 146 45 96.276718 and/or 5 1 36 1 1 12 1993 2032 79 37 96.669113 any 5 1 36 1 1 13 2096 2022 116 37 96.732056 other 4 1 36 1 2 0 403 2080 1104 49 -1 5 1 36 1 2 1 403 2081 188 39 94.663887 evidence 5 1 36 1 2 2 606 2081 88 38 94.663887 that 5 1 36 1 2 3 704 2092 25 27 93.169678 a 5 1 36 1 2 4 747 2081 304 45 91.089066 warrant/check 5 1 36 1 2 5 1065 2091 82 28 96.112335 was 5 1 36 1 2 6 1161 2081 193 48 95.079681 originally 5 1 36 1 2 7 1364 2080 143 38 94.810318 issued. 2 1 37 0 0 0 305 2182 1107 6 -1 3 1 37 1 0 0 305 2182 1107 6 -1 4 1 37 1 1 0 305 2182 1107 6 -1 5 1 37 1 1 1 305 2182 1107 6 95.000000 2 1 38 0 0 0 328 2197 955 67 -1 3 1 38 1 0 0 328 2197 955 67 -1 4 1 38 1 1 0 328 2197 955 67 -1 5 1 38 1 1 1 328 2197 316 45 92.369537 Warrant/Check 5 1 38 1 1 2 662 2197 167 38 78.121239 Number 5 1 38 1 1 3 920 2215 363 49 51.607670 3799409225 2 1 39 0 0 0 494 2252 221 35 -1 3 1 39 1 0 0 494 2252 221 35 -1 4 1 39 1 1 0 494 2252 221 35 -1 5 1 39 1 1 1 494 2252 34 35 72.596382 (if 5 1 39 1 1 2 540 2252 116 35 96.348297 known) 5 1 39 1 1 3 670 2252 45 35 96.783882 (6) 2 1 40 0 0 0 305 2286 1107 5 -1 3 1 40 1 0 0 305 2286 1107 5 -1 4 1 40 1 1 0 305 2286 1107 5 -1 5 1 40 1 1 1 305 2286 1107 5 95.000000 2 1 41 0 0 0 305 2185 3 210 -1 3 1 41 1 0 0 305 2185 3 210 -1 4 1 41 1 1 0 305 2185 3 210 -1 5 1 41 1 1 1 305 2185 3 210 95.000000 2 1 42 0 0 0 903 2184 3 210 -1 3 1 42 1 0 0 903 2184 3 210 -1 4 1 42 1 1 0 903 2184 3 210 -1 5 1 42 1 1 1 903 2184 3 210 95.000000 2 1 43 0 0 0 329 2301 1819 47 -1 3 1 43 1 0 0 329 2301 1819 47 -1 4 1 43 1 1 0 329 2301 1819 47 -1 5 1 43 1 1 1 329 2301 156 47 96.319969 Original 5 1 43 1 1 2 507 2302 95 37 96.367279 Date 5 1 43 1 1 3 620 2301 42 38 96.508560 of 5 1 43 1 1 4 677 2302 111 37 96.887291 Issue 5 1 43 1 1 5 1854 2308 294 34 62.299301 05/12/2021 2 1 44 0 0 0 305 2390 1107 5 -1 3 1 44 1 0 0 305 2390 1107 5 -1 4 1 44 1 1 0 305 2390 1107 5 -1 5 1 44 1 1 1 305 2390 1107 5 95.000000 2 1 45 0 0 0 330 2452 994 106 -1 3 1 45 1 0 0 330 2452 994 106 -1 4 1 45 1 1 0 330 2452 994 48 -1 5 1 45 1 1 1 330 2455 147 35 96.558136 Reason 5 1 45 1 1 2 495 2453 60 37 96.878601 for 5 1 45 1 1 3 571 2452 151 48 96.227829 original 5 1 45 1 1 4 742 2454 103 36 96.764778 issue 5 1 45 1 1 5 862 2453 42 37 93.296432 of 5 1 45 1 1 6 918 2452 317 45 92.655457 Warrant/Check 5 1 45 1 1 7 1251 2452 73 47 96.561249 (8): 4 1 45 1 2 0 400 2511 208 47 -1 5 1 45 1 2 1 400 2512 36 36 21.340546 C1 5 1 45 1 2 2 472 2511 136 47 94.892715 Payroll 2 1 46 0 0 0 400 2597 744 125 -1 3 1 46 1 0 0 400 2597 744 125 -1 4 1 46 1 1 0 400 2597 744 39 -1 5 1 46 1 1 1 400 2600 36 35 37.480694 LC 5 1 46 1 1 2 471 2599 67 36 92.819077 For 5 1 46 1 1 3 554 2599 173 37 96.629845 Services 5 1 46 1 1 4 744 2608 43 27 96.485138 or 5 1 46 1 1 5 803 2597 129 38 95.740143 Goods 5 1 46 1 1 6 949 2597 195 38 96.259102 furnished 4 1 46 1 2 0 469 2671 344 51 -1 5 1 46 1 2 1 469 2684 131 38 94.211327 Other: 5 1 46 1 2 2 633 2671 180 49 96.047913 Mileage 2 1 47 0 0 0 1146 2637 946 5 -1 3 1 47 1 0 0 1146 2637 946 5 -1 4 1 47 1 1 0 1146 2637 946 5 -1 5 1 47 1 1 1 1146 2637 946 5 95.000000 2 1 48 0 0 0 620 2723 1500 7 -1 3 1 48 1 0 0 620 2723 1500 7 -1 4 1 48 1 1 0 620 2723 1500 7 -1 5 1 48 1 1 1 620 2723 1500 7 95.000000 2 1 49 0 0 0 326 2921 1837 65 -1 3 1 49 1 0 0 326 2921 1837 65 -1 4 1 49 1 1 0 326 2921 1541 33 -1 5 1 49 1 1 1 326 2921 350 31 91.614998 S:\PROCESSES\Warrants 5 1 49 1 1 2 688 2935 10 3 92.173759 - 5 1 49 1 1 3 711 2922 128 32 96.924431 Duplicate 5 1 49 1 1 4 850 2928 29 19 92.726807 or 5 1 49 1 1 5 889 2922 116 30 70.747925 Stale\02 5 1 49 1 1 6 1018 2921 463 31 90.106300 Forms\Schools\Schools-Warrants 5 1 49 1 1 7 1492 2922 98 25 96.879517 Checks 5 1 49 1 1 8 1602 2922 82 25 96.595169 notice 5 1 49 1 1 9 1696 2921 29 26 92.958473 of 5 1 49 1 1 10 1734 2921 133 26 91.140976 claim.doc 4 1 49 1 2 0 327 2960 1836 26 -1 5 1 49 1 2 1 327 2960 103 26 96.874733 Revised 5 1 49 1 2 2 442 2961 66 25 96.752289 June 5 1 49 1 2 3 520 2961 68 25 95.860840 2015 5 1 49 1 2 4 1829 2961 84 25 69.138718 A.R.S, 5 1 49 1 2 5 1930 2961 94 25 92.694740 11-632 5 1 49 1 2 6 2036 2961 21 25 92.694740 & 5 1 49 1 2 7 2070 2961 93 25 96.589050 15-999 2 1 50 0 0 0 2545 1613 5 1681 -1 3 1 50 1 0 0 2545 1613 5 1681 -1 4 1 50 1 1 0 2545 1613 5 1681 -1 5 1 50 1 1 1 2545 1613 5 1681 95.000000 V and sworn to before me this ‘Oil Date: 5/7/22021 To whom it may concern: The check listed in the attached documents was not received in the mail please reissue. Thank you Jennifer Kaise i i