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MARICOPA COUNTY sur3E;cy Couy - Department of Finance 301 West Jefferson, Ste 960 2019 JUL 1 1 AM 9: 52 ompt.el Phoenix, Arizona 85003 INTEROFFICE MEMORANDUM Date: July 11,2019 To: Clerk of the Board From: Nadine Higuera Department of Finance Subject: Affidavits — Replacement of Stale-dated Warrant Please find attached 1 Affidavit for stale-dated warrant to be included on the next available Board Agenda. • The attached items have been researched to ensure the warrant in question have not been cashed or previously re-issued. • The original warrants have a void/stale date/stop payment done. Please call me at 506-1354 if you have any questions. Please return the approved Affidavits to my attention in the Department of Finance, Suite 960. Thank you. Re: J & D Enterprises Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: E] Duplicate or al Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is paw 2 of this form. J & D Enterprises (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 09-May-2018 (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 beAssued to him/her in the sum of $122.78 .(3) Signed: (4) Note: Please attach a co #y of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Notary Public State of Arizona My commission 'expires: Maricopa Nohemi Martinez County Arrona 02-/k)/ My Commission Expires 0410112020 (seal) 873729 Original Date of Issue 09-May-2018 (if known) (7) Reason for original issue of Warrant/Check (8): D Payroll O For Services or Goods furnished O Treasurer's refund/payment Other: staledated J & D ENTERPRISES June 24, 2019 Maricopa County Department of Finance Attn: Nadine 301 W Jefferson Suite 960 Phoenix, Az 85003 To Whom It May Concern: Gina Cooper is our Accountant and a signer on all of our checks. She is authorized to act on my behalf for all of our J 8.< D Enterprises Accounts with you. You may telephone and email information to her. Gina can be reached at the following email address and telephone number: Email: gcooper.az@gmail.com Telephone: 657 245-3449 I can be reached at telephone number 323 227-1933 Thank you. Sincerely, 1700 Adams Avenue, Ste. 102 • Costa Mesa, CA 92626 Office (657) 245-3449 • FAX (714) 556-1550