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MARICOPA COUNTY Office of Budget and Finance 301 West Jefferson Street Ste 960 , Phoenix, Arizona 85003 INTEROFFICE MEMORANDUM Date: April 9, 2021 To: Clerk of the Board From: Walter Chang Office of Budget and Finance Subject: Affidavits — Replacement of Lost Warrants Please find attached 1 Affidavits for lost warrants to be included on the next available Board Agenda. e The attached items have been researched to ensure the warrant in question have not been cashed or previously re-issued. e The original warrants have a void/stale date/stop payment done. Please call me at 506 - 8747 if you have any questions. Please return the approved Affidavits to my attention in the Office of Budget and Finance Suite 960. , Thank you. Re: Fund: 100 / Dept: Justice Courts / Company: MARIA PAYAN ROMERO RICO Application for a Duplicate or Stale-Dated Warrant/ Check ote a Affidavit /Claim Form Couns This application is for: CJ Duplicate or Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is paae 2 of this form. MARIA PAYAN ROMERO (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 12-Sep-2019 (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 $ 131.00 (3) L A, / P vat Signed: Lica lily A (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_ OW day of Apr | 2021. NOTARY PUBLIC- SE Francisca Tamayo Warrington \ Notary Public My co ission expires: Maricopa County, Arizona 2. My Comm. Expires 01 nee as A O ) Warrant/Check Number 30100428390 ‘ie known) (6) Original Date of Issue 12-Sep-2019 (if known) (7) i Reason for original issue of Warrant/Check (8): 01 Payroll / REFUND DOWNTOWN JUSTICE COURT CT2017-043078 For Services or Goods furnished O Treasurer's refund/payment / original check presumed lost in the mail Other: Walter Chang (FIN) From: David Marquez (MJC) < Sent: Wednesday, March 31, 2021 12:04 PM To: Walter Chang (FIN) Subject: FW: CT2017043078 MARIA PAYAN ROMERO Warrant Number 3010042890 Walter, Can you assist me with this warrant. What are the options for Maria Romero? Do you have the check? Warrant Number - 3010042880 Sietes Account # Feed fate steed Data Regaiciod Date Pages MARIS PAYEN ROVERS Aston! S138 02 iiterwat he Ciem# Sub Fund Cept® Pod Lowitig Wistar From: Minnie Uribe (MJC) < AM Sent: Wednesday, March 31, 2021 11:56 To: David Marquez (MIC) < Cc: Minnie Uribe (MJC) <: ROMERO Subject: CT2017043078 MARIA PAYAN David, This refund check was processed back in August 2019 — defendant is stating they never received. Will you please check to see if check was sent back. | have a better address for them now. Thanks, Minnie V Uribe Court Manager Downtown Justice Court Phoenix Arizona 85003 Tel: - Fax: