ARIZONA EDUCATION ASSOCIATION .PDF

RECEIVED
NOV 2 5 2019
CLERK= 0 FCSUPERVISORS
INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 11/25/2019
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.vsaguirre@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 Arizona Education Association $7,406.95

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.
Pa fedIat /4. 54eing K -. Y (1), n being 24 ' llei first elue-ah sworn, upon v oath deposes and says:
Na e/Clalmant
On or about tu/ C/2.01 (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 $ VD‘ 15 (3)
Signed: (4)
(5) Subscribed and sworn to before me this -2-i day of JIfoi--‹,,h,e- 20 iq .
NOTARY PUBLIC DEBORAH EBANKS
Notary Public- State of Mizoria
My commission expires: My MAR1COPA Commission COUKTY Expires
izoit November 8, 2021 (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
(if known) (6)
Original Date of Issue ii/6/zi y
(if known) (7)
APPROVED
Reason for original is ue of Warrant/Check (8):
S Payroll 72i DATE NOV 2)6 2019
0 For Services or Goods furnished
LI Other:
S:\PROCESSES\Wrrarits - Duplicate or Stale\02 Forms\Scho )Is\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 & 15-999

Arizona November 25, 2019
Education
Association
Ms. Elizabeth Bernal
345 East Palm Lane Payroll Specialist
Phoenix, AZ 6000 S. 7th Street
85004-1532 Phoenix, AZ 85042
(602) 264-1774
(800) 352-5411 Dear Ms. Bernal,
FAX
(602) 240-6887 Via this letter, I am affirming to you that Margaret M. Sleeper, Business Manager
of the Arizona Education Association, is an Authorized Signer on our bank
Web site: accounts.
w W w.t-u-izonaea.org
Sincerely,
Joe Thomas, President
ARA's MISSION
AEA...
keeping the
promise of
quality
public
education