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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: 7/29/2019 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. #60 Higley Unified Lindy Adams $256.59 #90 Saddle Mountain Unified Tequila Boyd $480.00 #45 Fowler Elementary ACCEL/Latch School $12,510.00 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 OUNTY OF MARICOPA Instruction sheet which is page 2 of this form. anA (1), being first sworn, upon oath deposes and says: lirrg On or about j a4'7er.113)21)/ (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/chkk,lie issued t him/her in the sum of $ g06-2—t? .(3) Signed: (4) 5i Subscribed,and sworn topefore me this 23 day of .3 LD - 20 Eir11440,L)2. NOTARY PUBLICv mb.a.db.shrawis.•I•II•I•II•ahAh4 DOROTHY B HERNANDEZ Notary Public -Arizona riWair 1r9".bPr My Comm. Maricopa Expires County Mar 22. 2022 (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 10019 0:cicrl (if known) (6) Original Date of Issue (if known) (7) Reason for original issue of Warrant/Check (8): A IV ti 0 if A.,) 0 Payroll DAT- AUG 0 1 2019 0 For Services or Goods furnished dr`AT)74-rwamp-,, Other: toSi tr. r"u1 .[ " ARC* -A 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 Saddle Mountain Unified School District #90 38201 West Indian School Road Tonopah, AZ 85354 Fax 623-474-5190 July 23, 2019 To whom it may concern: I Tequila Boyd never received check number 90560451 for $480.00 dated 06/13/2019. After inquiry, it was discovered that my address on file was wrong, and the check is missing in the mail. ,ncerely, equila Boyd