Extracted text (via tesseract_tsv)
2526 characters
INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 1/28/2021
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.
v 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.
#60 Higley Unified Tina Ochoa Quinonez $1,186.07
Zit raw
RECEIVED
JAN 29 7073
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
Schools Affidavit/Claim Form
Application fora 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.
Tina Ochoa Quinonez (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 12/14/2020 (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
1186.07
warrant/check be issued to him/her in the sum of $ AS)
Signed: twee (Qu IY OVE (4)
5
(5) Subscribed and sworn to before me this R] day of Sanuardg_ 2021.
ihe
Vg {) mK
NOTARY PUBLIC tary Public - Arizona
MARICOPA COUNTY
My commission expires: Evoiue eco
12/14/2020 (seal)
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
3700382897
(if known) (6)
Original Date of Issue
12/14/2020
(if known) (7)
Reason for original issue of Warrant/Check (8):
lm Payroll
01/29/2021
-
1 For Services or Goods furnished
LC) Other:
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