STAMPED & REDACTED CARL EASTIN.PDF

CLERK ;
(ARICOPA COUNT Y Human Resources
1}: 32
Wend Deki very dR
To: Cindy Goelz, Clerk of the Board
From: Lisa Platek
Date: April 8, 2021
Re: Replacement of Lost Payroll Warrants
Please find attached _1 __ Affidavit/Notice of Claim(s) for lost
payroll warrants for inclusion on the next available Board agenda.
The attached item(s) have been researched to ensure that the
warrant(s) in question have not been cashed or previously re-
issued. The original warrant(s) have had a stop payment done.
Please call Lisa P at ext. 63619 for any questions. Please route
Stale Dated Warrant
Thank you.
Replacement Lost Warrant Form | 02/25/2015

. Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: Duplicate or _] Stale-Dated (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.
Carl Eastin (1), being first sworn, upon oath deposes and says:
Name/Claimant
93/17/2021
On or about (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 $478.57 (3)
Signed: Cork Cut. (4)
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this_Q7 day of Prov \ 202\..
a - ™
NOTARY
PUBLIC RGETHI VALENCIA
TS Note Public - State of Arizona
ARICOPA COUNTY
My commission expires: Commission # 551446
Expires July 22, 2022
1-P2- 762-2 (seal)
balhale tees y eal 23049907
Original
Date of Tssue 03/17/2021
Reason for original issue of Warrant/Check (8):
@ Payroll
C1 For Services or Goods furnished
C1 Treasurer’s refund/payment 04/09/2021
|
L] Other:
Revised April 2015

Name Eastin Carl J Confirmed Check
—
- Earnings : a Bane : Deductions.
23049907 «(03/17/2021 69.18
laste oe
ADP Enterprise HR screen print as of: 04/08/2021 11:18 AM

432 SmartCompliance Updated 2/26/2021
HOME PROCESSES
“Management & Reversals
Look up the details of a single payment or range of payments by using the form below,
© NOTE: The maxdmuni check range is limited to 50 checks per request. :
CHECK SEARCH DIRECT DEPOSIT SEARCH
| BRANCH COMPANY CODE CHECK NUMBER {23049907
_ [C) Range ot Check Numbe
ry} Range of Dates
SORT BY. STATUS: ALL Search
Eastin Carl J # 23049907 tr #
a
$478.57 issued on 03/47/2021 Unpaid/Uncashed

Maricopa County
Human Resoutces
Payroll & Employee
Records Division
301 West Jefferson Street
Suite 220
Phoenix, AZ 85003-2143 DATE: April 8, 2021
Phone: 602-506-3519
Payroll Fax: 602-372-0277 . _ ;
Records Fax: 602-506-5509 TO: Eileen Williams/ Lisa Platek
www.maricopa.gov .
FROM: Lisa Platek
RE: Stop Payment on Warrant
Please place a stop payment on the Warrant listed below. It has been
determined that the Warrant is outstanding as of this date:
Warrant Number: 23049907
Issue Date: 03/17/2021
Payable to: Carl Eastin
Amount: $478.57
Reason for Stop Payment: never received
Attach a print screen of the paycheck view.
y Nrectnaien er
Authorized Signature — Payroll Specialist
Hh 5 D024 LI Cl Aad
Date Stopped Stopped by
y & | LISLE, {| ; LU Mtr »
Transaction Number Stopped

#32 SmartCompliance _ CQVID49 UPDATES Updated 2/26/2021
HOME PROCESSES
= Look up the details ofa single payment or range of payments by using the form below.
NOTE: The maximum check range ts limited to 50 checks per request.
K SEARCH DIRECT DEPOSIT SEARCH
C) Range of Check Numbers ©
SORT BY: NANG AMOUNT: STATUS: ALL » Search
Eastin Carl J i # 23049907
it
heck
$478.57 issued on 03/7/2021 Stopped/Void as af 04/08/2021