SIGNED NEWSELA INC FOR 021021 AGENDA.PDF

INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
7
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TO: CLERK OF THE BOARD Or,
JAN 13 2021
FROM: _ Terri Ysaguirre
MARICOPA COUNTY
SUBJECT: Affidavits — Replacement of Lost Warrants
CLERK BOARD OF SUPERVISORS
DATE: 1/12/2021
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.
#66 Roosevelt Elementary NEWSELA Inc $4500.00

{
| JAN 06 202
Schools Affidavit/Claim Form |
BY kc mance
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.
NEWSELA INC (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 12/18/2020 (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
4500.00
warrant/check be issued to him/her in the sum of ¢ (3)
Signed: hexh/Aa-— (4)
(JY Z
—
(5) Subscribed and sworn to before me this __20th__day of December 2020
af Z
NOTARY PUBLIC (RIAN BERMAN
NOTARY PUBLIC-STATE OF NEW YORK
My commission expires: No. 01BE6370332
Qualified in Queens County (seal)
4214812020
My Commission Expires 01 -29-2022
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
Warrant/Check Number
3700339221
(if known) (6)
Original Date oF sue (07/22/2020 01/19/2021
|
Reason for original issue of Warrant/Check (8):
OO Payroll
O For Services or Goods furnished
m Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
A.R.S. 11-632 & 15-999
Revised June 2015

LT}
newsela
Newsela, Inc.
Warrant Letter
January 11, 2021
To Whom it May Concern:
This letter confirms that Newsela, Inc. is not in receipt of check #3700339221 for
§4,500.00 issue by the Treasurer of Maricopa County on behalf of Roosevelt Scool
, ;
District No. 66.
Sincerely,
Chris Mezzatesta
Chief Revenue Officer Newsela