SHARP.PDF

MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: February 11,2019
To: Clerk of the Board
s:-
From: Walter Chang
Department of Finance
Subject: Affidavits — Replacement of Lost Warrants
Please find attached 1 Affidavits for lost warrants 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.
The two separate amounts for $240.00 and $760.00 all belong on check number
3010018536.
Please call me at 506 — 8747 if you have any questions. Please return the approved
Affidavits to my attention in the Department of Finance, Suite 960.
Thank you.
Re: Fund: 219 / Dept: COUNTY ATTORNY / Company : Stacie Sharp

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: " 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
pane 2 of this form.
Stacie Sharp (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 30-Oct-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 issued to hi her in th sum of $ 240.00 .(3)
Signed: LI 00) (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) Sub§cribed and sworn to before me this day of fe-- 20 12.
rishami„„mowp--
. KATHY ALLEN
My commission expires: Notary Public, State of Arizona
/ My Commission Maricopa County Expires (seal)
)uly 18, 2021
Warrant/Check Number 000003010018536
(if known) (6)
Original Date of Issue 17-Oct-2018
(if known) (7)
Reason for original issue of Warrant/Check (8):
0 Payroll
El For Services or Goods furnished
0 Treasurer's refund/payment
0 Other: Duplicate Check - Victim Compensation(VC2016000809-1)
G2Q4b, - Wto- kt-r) 5 cI

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: v Duplicate or 0 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.
Stacie Sharp (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 30-Oct-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/che issued to him/her in e sum of $760.00 .(3)
Signed: 0/44 (4)
Note: Please attach a copylof the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this L4-,/ day of 7-7613 20
PdBLIC
KATHY ALLEN
My commission expires: y Public, State of Arizona
7 - I - / rAy ivisricopa Commission County Expires (seal)
July18, 2021
Warrant/Check Number 000003010018536
(if known) (6)
Original Date of Issue 17-Oct-2018
(if known) (7)
Reason for original issue of Warrant/Check (8):
O Payroll
O For Services or Goods furnished
O Treasurer's refund/payment
Other: Duplicate Check - Victim Compensation(VC2016000809-1)--c
CDA-1(4- - AD I q VW? 5 c)

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY WARRANT NUMBER
PHOENIX, ARIZONA 3010018536
DATE
10-30-2018 91-2/1221
JPMorgan Chase Bank N.A
Phoenix, AZ
One Thousand And 00/100 Dollars
$1,000.00
PAY TO THE ORDER OF
AMOUNT
Stacie Sharp
301 W Jefferson 9th Floor
PHOENIX AZ 85003 Void After
365 Days
For Questions - 602-506-1379 or email AP@MAILMARICOPA.GOV NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR PAYEE WARRANT NO. WARRANT DATE WARRANT AMOUNT
YOUR RECORDS
VICTIM WITNESS 3010018536 10/30/2018 $1,000.00
INVOICE NUMBER DESCRIPTION PURCHASE ORDER NO. VOUCHER NO. AMOUNT
00000049844K VC2016000809-1-rqst4 GAX1D D190 190000014759 240.00 CA
190000014759
00000049844K VC2016000809-1-rqst5 GAX1D D190 190000014759 760.00 CA
190000014759