SIGNED DURAND WHITE DBA DURAND WHITE PRODUCTION AND FILM FOR 021021 AGENDA.PDF

MARICOPA COUNTY
Office of Budget and Finance
301 West Jefferson Street Ste 960
,
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM oO
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Date: December 29, 2020 =
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To: Clerk of the Board nh °
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From: Walter Chang q
Office of Budget and Finance
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Subject: Affidavits — Replacement of Lost Warrants
Please find attached 1 Affidavits for lost warrants to be included on the next available
Board Agenda.
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 Department of Finance, Suite 960.
Thank you.
Re: Fund:200 / Dept :220 - Human Services Dept. / Company : Durand White DBA: Durand White
Production and Film

py. 02
Application for a Duplicate or Stale-Dated Warrant/Check wep,
Affidavit/Claim Form Count,
This application is for: Duplicate or C] 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.
Durand White DBA: Durand White Production and Film (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 16-Oct-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
5
warrant/check be issued to him/her in the sum of $ 7,900.00 ‘y . “@) ‘
Qucund Whihe
Signed: (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 4 dayof Dec 2020.
Card MN Crbe
NOTARY PUBLIC
My commission expires: vouny Riblie Swe
Val) 19/202 2Y yee! Maricopa County (seal)
Z Commission # 589706
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Warrant/Check Number
|3949070156
(if known) (6)
Original Date of Issue
Reason for original issue of Warrant/Check (8):
[1 Payroll
/ COVID rental payment
For Services or Goods furnished
[11 Treasurer's refund/payment
Original check presumed lost in the mail
Other:
01/11/2021

DURAND WHITE PRODUCTIONS
Durand White
December 8, 2020 Shite sore
o8y of Mericapa
|, Durand White, Administrator, to execute an affidavit on
bed and swim (or afimned) beforems this_ 22
5	1	10	1	2	8	2269	985	15	6	0.000000	“
2	1	11	0	0	0	1779	1011	69	5	-1	
3	1	11	1	0	0	1779	1011	69	5	-1	
4	1	11	1	1	0	1779	1011	69	5	-1	
5	1	11	1	1	1	1779	1011	69	5	95.000000	 
2	1	12	0	0	0	1851	1008	4	10	-1	
3	1	12	1	0	0	1851	1008	4	10	-1	
4	1	12	1	1	0	1851	1008	4	10	-1	
5	1	12	1	1	1	1851	1008	4	10	75.754990	1
2	1	13	0	0	0	1814	1144	204	31	-1	
3	1	13	1	0	0	1814	1144	204	31	-1	
4	1	13	1	1	0	1814	1144	204	31	-1	
5	1	13	1	1	1	1814	1144	97	29	70.390442	Netary
5	1	13	1	1	2	1926	1147	92	28	39.043484	Public
2	1	14	0	0	0	1949	1129	378	17	-1	
3	1	14	1	0	0	1949	1129	378	17	-1	
4	1	14	1	1	0	1949	1129	378	17	-1	
5	1	14	1	1	1	1949	1129	378	17	95.000000	 
2	1	15	0	0	0	280	1201	223	41	-1	
3	1	15	1	0	0	280	1201	223	41	-1	
4	1	15	1	1	0	280	1201	223	41	-1	
5	1	15	1	1	1	280	1201	114	32	96.105072	Yours
5	1	15	1	1	2	408	1201	95	41	95.436768	truly,
2	1	16	0	0	0	283	1279	482	97	-1	
3	1	16	1	0	0	283	1279	482	97	-1	
4	1	16	1	1	0	283	1279	482	97	-1	
5	1	16	1	1	1	283	1279	235	97	24.706387	Yyvrand
5	1	16	1	1	2	556	1310	53	55	48.032436	A
5	1	16	1	1	3	634	1286	131	78	0.000000	Wits
2	1	17	0	0	0	283	1418	435	42	-1	
3	1	17	1	0	0	283	1418	435	42	-1	
4	1	17	1	1	0	283	1418	435	42	-1	
5	1	17	1	1	1	283	1419	241	41	95.527885	DURAND
5	1	17	1	1	2	541	1418	177	42	95.527885	WHITE
2	1	18	0	0	0	875	1346	631	158	-1	
3	1	18	1	0	0	875	1346	631	158	-1	
4	1	18	1	1	0	1366	1346	140	100	-1	
5	1	18	1	1	1	1366	1346	140	100	95.000000	  
4	1	18	1	2	0	875	1446	631	58	-1	
5	1	18	1	2	1	875	1468	197	36	95.000000	 
5	1	18	1	2	2	1477	1446	29	22	95.000000	 
2	1	19	0	0	0	875	1346	307	122	-1	
3	1	19	1	0	0	875	1346	307	122	-1	
4	1	19	1	1	0	875	1346	307	122	-1	
5	1	19	1	1	1	875	1346	307	122	95.000000	   
2	1	20	0	0	0	1075	1393	389	162	-1	
3	1	20	1	0	0	1075	1393	389	162	-1	
4	1	20	1	1	0	1182	1393	184	25	-1	
5	1	20	1	1	1	1182	1393	80	23	91.942528	GAROL
5	1	20	1	1	2	1269	1395	97	23	96.016472	MCCABE
4	1	20	1	2	0	1135	1426	277	28	-1	
5	1	20	1	2	1	1135	1426	79	28	96.040535	Notary
5	1	20	1	2	2	1224	1428	72	23	93.169960	Public
5	1	20	1	2	3	1306	1439	7	5	92.853409	-
5	1	20	1	2	4	1320	1430	92	23	96.295090	Arizona
4	1	20	1	3	0	1172	1459	202	30	-1	
5	1	20	1	3	1	1172	1459	108	29	96.165199	Maricopa
5	1	20	1	3	2	1290	1460	84	29	96.368439	County
4	1	20	1	4	0	1140	1492	263	26	-1	
5	1	20	1	4	1	1140	1492	141	24	93.235970	Commission
5	1	20	1	4	2	1292	1494	14	22	91.830902	#
5	1	20	1	4	3	1316	1495	87	23	96.799667	589706
4	1	20	1	5	0	1075	1524	389	31	-1	
5	1	20	1	5	1	1075	1524	34	27	94.958557	My
5	1	20	1	5	2	1118	1525	82	23	89.306587	Comm,
5	1	20	1	5	3	1213	1526	86	27	96.406029	Expires
5	1	20	1	5	4	1309	1528	40	23	96.251839	Oct
5	1	20	1	5	5	1361	1528	33	27	96.251839	19,
5	1	20	1	5	6	1407	1529	57	23	96.599495	2024
2	1	21	0	0	0	875	1468	631	122	-1	
3	1	21	1	0	0	875	1468	631	122	-1	
4	1	21	1	1	0	875	1468	631	63	-1	
5	1	21	1	1	1	875	1504	197	27	95.000000	 
5	1	21	1	1	2	1477	1468	29	63	95.000000	  
4	1	21	1	2	0	875	1531	629	59	-1	
5	1	21	1	2	1	875	1531	200	59	95.000000	 
5	1	21	1	2	2	1464	1531	40	59	95.000000	 
2	1	22	0	0	0	2542	3	8	3266	-1	
3	1	22	1	0	0	2542	3	8	3266	-1	
4	1	22	1	1	0	2542	3	8	3266	-1	
5	1	22	1	1	1	2542	3	8	3266	95.000000 _ gey ai
behalf of DURAND WHITE PRODUCTIONS. ;

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