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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: 2/2/2021 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. If 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. #25 Liberty Elementary Jennifer Ledlow $400.00 AO Mert os SENT JIT RECENV c ue => >y FEB 19 202) MARICOPA COUNTY CLERK BOARD OF SUPERVISORS 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. Van jee ( ed low (1), being first sworn, upon oath deposes and says: “Name/Claimant On or about Aol ZO 2020 (cate)(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 Yoo 00 warrant/check be issued to him/her in the sum of $ (3) y Vows (4) Signed: ar (5) Subscribe swom to before me this__Z/ day of Lttoker 20.20. wat hag ' ae: i) é PUBLIC gf BOR age’ ees oe One NOTARY My co issio iden Oe [2024 Sees * Note: Please attach a copy of the warrant/check if available and/or aoy, Say evidence that a warrant/check was originally issued. Warrant/Check Number 37 003206262 (if known) (6) / Original Date of Issue 2o/ ut] ZO Z0 (if known) (7) Reason for original issue of Warrant/Check (8): 02/22/2021 O) Payroll 7 O For Services furnished ae nN Other: cel dip Aspen ; 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