STAMPED & REDACTED GREYSTAR EQUITY PARTNERS IX REIT LLC.PDF

MARICOPA COUNTY BOARD OF SU Fe
vIS0
Office of Budget and Finance MES GOUNT Y
301 West Jefferson Street Ste 960 2021 HAR 29 PH
, 3: 36
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: March 29, 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: 200 / Dept: Human Services / Company: GREYSTAR EQUITY PARTNERS IX REIT LLC

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form
This application is for: Duplicate or ["] state-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Nurmbers oni this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
pade 2 of this form.
GREYSTAR EQUITY PARTNERS IX REIT LLC (1) being first sworn, upon oath deposes and says:
t
Name/Claimant
On or about 14-Dec-2020 (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/chec t of ¢. 1,500.00 (3)
igled
WE
Signed: _ (Vs. WAR (4)
—S
Note, Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subsgribed and sworn to before me this Y day of Macch 20A/.
ARY PUBLIC Gh CaN ay Thee items = Situ
A, JORDAN HERMES
Notary Public - Arizona
Pinal County
My commission expires: Commission # 564462
Moy hb, do. 27 Wy Comm, Expres Hay 2, 2073 | (seal)
Warrant/Check Number
tf 301 0077070
; known) (6)
Original oe Date of Issue
14-Dec-2020
fit knowen (71 03/30/2021
|
Reason for original issue of Warrant/Check (8):
O1 Payroll
For Services or Goods furnished / COVID rental payments
1 Treasurer’s refund/payment
Other: / Original check presumed lost

03/04/2021
|, Liz Shumar, authorize Courtney “Charlie” Miller, Business Manager, to execute
an affidavit on behalf of Avana Chandler Apartment Homes.
Respectfully,
iananr
ca:
Liz Shumar | Senior Community Manager
Avana Chandler | | Chandler, AZ 85226
o |
Proudly managed by Greystar®
Chandler, AZ 85226
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OPPORTUNITY