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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 9/30/2019 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.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 Christopher Brock $1,032.98 (Stale Dated) #60 Higley Unified Brian D Shepherd $408.01 #60 Higley Unified The Stander Group Inc $3,750.00 #45 Fowler Elementary Cindy Hunt $446.55 #47 Arlington Elementary Fernando Barron $93.45 RECEIVED OCT 01 2019 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS 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. CHRISTOPHER BROCK (1), being first sworn, upon oath deposes and says: Name/Claimant On or about S 64,- Oh? (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 $ 1,032.98 .(3) Signed: (4) (5) Subscribed and sworn to before me this 0 day of SEPT 20/ C1 N TARY PUBLIC •I.0N 'cr3 C90999$ .N1103 Vd0011:1VNI • ., ;f: - oticind A-1910N My commission expires: NOiSCA )1 3 NVr \ris VOlO (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 3700067431/60563956 (if known) (6) Original Date of Issue 08/06/2018 (if known) (7) Reason for original issue of Warrant/Check (8): Payroll El For Services or Goods furnished El 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 September 26., 20119 Higley: USD #60 Human Resources Department Attn: Devionna Phillips CCEIR'(AP class) Cheek To 'Whom it May Concern, Last school year; 2018-2019, the Higley district instituted a bonus check for teachers of AP dasses. I became aware of this only on Tuesday, 9/24/19 When I received a cheek, The check I was issued last year I never received. I believe this is due to the fact no one notified me via email about the check while I as out on disability Iciiget my hips replaced. I was on disability and FMLA from 9/25/1 -8 to 1/17/19, Thanks for your attention to this..matter. Please .reissue the check. Sincerely, Clnistopher Brock Riology Teacher Williams Field High•Selioal (480)27978000 x-2.1259 chris.brock@huslorg. Sohcia, 2076 Singhilligley.ROca Gilber't. AZ 85295; 480 -279- 8000