ARIZONA SCIENCE ASSOCIATION.PDF

INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 6/19/2019
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@mcesa.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.
#65 Tolleson Union Arizona Science Teachers Association $2,575.00
RECEIVED
JUN 21 2019
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
-T1 o fk,

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.
Arizona Science Teachers Association (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about March 12, 2019 (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 $ 2,575.00 .(3)
Signed: (4)
(5) Subscribed and sworn to before me this I a day of L..) I(\e 20 19.
NOTARY PUBLIC
CORAIMA C AGUAYO
My commission expires: Notary Pima Public County - Arizona
10 - 2S- - 2027_ My Comm. Commission Expires # Oct 553743 25, 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 3700155103/214756419
(if known) (6)
Original Date of Issue 3/12/19
(if known) (7) a li 0 iii
Reason for original issue of Warrant/Check (8): DATE
El Payroll
For Services or Goods furnished FEES MARICOPA K, COUNT' BO ARD OF SUPE ,
El Other:
S:\PROCESSES\Warrarits - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 & 15-999

Science Teachers
Association
ASTA June 12, 2019
UofA Flandrau Science Center
& Planetarium
1601 E University Blvd
PO Box 210091
To Whom It May Concern,
Tucson, AZ 85721-0091
520-709-1886
www.azsta.org Sara Torres, Executive Director of the Arizona Science Teachers
Meg Gebert Association, is the authorized individual to sign the School
President Affidavit/Claim Form requesting a replacement warrant/check to be
Geneva Baker issued to Arizona Science Teachers Association for the sum of
President Elect $2,575.00 from Tolleson Union High School District.
R. Bruce Jones
Past President Please remit payment to: Arizona Science Teachers Association.
Danielle Coleman
Recording Secretary The warrant/check should be sent to:
Kim Adkins
Treasurer ASTA
UofA Flandrau Center
Phil McBride
Membership Secretary 1601 E University Blvd.
Tucson, AZ 85721-0091
Elizabeth Colton - Region I
Tanya Wright—Region II
Sincerely,
Kristi Goeke - Region III
Amber Struthers - Region IVE
Matthew Schmitt - Region IVW ZeUt
Paul Anger - Region V Meg Geb
Robyn Yewell - Region VI
ASTA 2019 President
Karl Griffor - Region VII
Rellie Lawyer - Region VIII
Carmelita Locke - Region IX
Edwin Saganey - Region X
Michelle Weidinger - Region XI
Sara Torres
Executive Director
astaexecdir@gmail.com
Inspiring, engaging, and supporting science teachers
in preparing STEM learners for success