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MARICOPA COUNTY Department of Finance 301 West Jefferson, Ste 960 Phoenix, Arizona 85003 INTEROFFICE MEMORANDUM Date: March 15, 2019 To: Clerk of the Board From: Marcia J. Clark Department of Finance Subject: Affidavit— CALVIN EASTLEY 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 warrant is lost. Please call me at 506-7291 if you have any questions. Please return the approved Affidavits to my attention in the Department of Finance, Suite 960. Thank you. Re: FUND-716, BSA: 2270, 0190 COUNTY ATTORNEY, MVICTIM, GAX1D 17*48964 & GAX1D 18*11342 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: 0 Duplicate or El 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 bade 2 of this form. Calvin Eastley (1), being first sworn, upon oath deposes and says: Name/Claimant On or about See attachment (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 i5,56e to him/her i sum of $ See attachment .(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) 5.ullscribed and p before me this 21 day of RUDY MORENO MACIAS JR Notary Public - Arizona Maricopa County My misision expires: _ My Comm. Commission Expires # Oct 552640 31, 2022 3-1,/t2v (seal) 7 Warrant/Check Number e et:76) ,e1e77 (if known) (6) See attachment 00006) Original Date of Issue 7/, _.9/t-7- (if known) (7) /0/8 717- Reason for original issue of Warrant/Check (8): O Payroll O For Services or Goods furnished O Treasurer's refund/payment Other: FPIP Restitution RECEIVED MAR 1 5 2019 CR2016-114931-001 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS Summary of Unclaimed Funds Warrant Date Warrant # Victim Amount Invoice # 07/03/17 380000029 Calvin Eastley $145.00 CR2016-114931-001-1 10/18/17 380008107 Calvin Eastley $65.00 CR2016-114931-001-2