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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 3/1/2019 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. #216 Agua Fria Union KMC Booster Club $225.00 RECEIVED MAR 0 4 2019 IVIARICOpp, COUNTY CLERK BOARD OF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: =I Duplicate or Stale-Dated (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. ;/' cry-J-e-y- Clul) (1), being first sworn, upon oath deposes and says: Name/Claimant On or about July 10, 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 be issued to him/her in the sum of $ 225.00 .(3) Signed: (4) Note:' Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribed and orn to before me this t1'" day Of c__, r 20 1 . NOTA- 'exI BLC " Thc —F—br ar o 0 ea Toledo Notary Public - Arizona Maricopa County cl)IrYintprilission expires: , My Commission Expires Nl.o\L'I .3 60 k May 14, 2021 witanrIVrila Warrant/Check Number 3700058331 (if known) (6) Original Date of Issue July 10, 2018 (if known) (7) AP Reason for original issue of Warrant/Check (8): DATE MAR 0,8 2019 CI Payroll El For Services or Goods furnished ;/.;\ :-- co pTc1o uTq ID Treasurer's refund/payment 111 Other: to pay for a Marching Invitational S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644 z Kellis Marching Corps Booster Club Supporting the Raymond S. Kellis High School Music Program PO Box 3082 Peoria, AZ 85345 February 11, 2019 Agua Fria Union High School District Attn: Accounts Payable 1481 N Eliseo Felix Jr Way Avondale, AZ 85323 Re: Check Number 9700058331 To whom it may concern: Enclosed is the Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form. We are requesting a duplicate check because the original check was lost. The signer on the Affidavit/Claim, Robyn Munro, is the President of KMC Booster Club and is an authorized signer for the organization. Thank you for your assistance in replacing the payment of Millennium's fee for the Kellis Classic. Sincerely, Steffanie Seletstewa Secretary KMC Booster Club