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INTEROFFICE MEMORANDUM TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 2/11/2021 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda Vv 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. #59 Laveen Elementary Seesaw Inc $1,226.50 De Ne RECEIV ED FEB 12 2021 MARICGPA COUNTY CLERK BOARS CF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/ Claim Form This application is for: Duplicate or C1 state-Dated (definitions are on page 2) STATE OF Florida Note: Numbers on this form correspond to numbers on the COUNTY OF Miami-Dade Instruction sheet which is page 2 of this form. Seesaw, Inc (1), being ee first sworn, upon oath deposes and says: . oe On or about 11/09/2020 (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/check be issued to him/her in the sum of $ 1226.50 (3) Signed:/b-ahe Evtracta (4) Ibrahim Estrada 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 ___27th_ day of _January 2021. Cc ivers licens vi | i trada i} bp iv ely, SONYA WASHINGTON NOTARY PUBLIC ae a & Notary Public - State of Florida Online Notary Z\o Commission # GG182756 My commission expires: Expires on February 5, 2022 02/05/2022 (seal) Notarized online using audio-video communication | Warrant/Check Number * |3799374909 (if known) (6) Original Date of Issue 11/05/2020 (if known) (7) 02/12/2021 Reason for original issue of Warrant/Check (8): OO Payroll For Services or Goods furnished C1 Treasurer's refund/payment Seesaw for Schools (1 Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644 180 Montgomery, Suite 750 San Francisco CA 94104 February 5th, 2020 To: Laveen Elementary School District To Whom It May Concern: | lbrahim Estrada, a representative of Seesaw Learning inc, state that payment for services provided to the Laveen school District was not received. The check has been declared lost in the mail. Payment is in the amount of $1226.5. Best, Ibrahim Estrada Analyst leach