021319 STALE DATED WARRANTS 1.PDF

MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
TA.
Date: January 23, 2019 ?/.
1\3
To: Clerk of the Board -7)
From: Marcia J. Clark
Department of Finance
Subject: Affidavit — TRUST ACCOUNT OF QUARLES & BRADY LLP
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: TRUST ACCOUNT OF QUARLES & BRADY LLP (MARICOPA COUNTY TREASURER
WARRANTS) ***Please see attached*****

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 Duplicate or 1 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
oacle 2 of this form.
TRUST ACCOUNT OF QUARLES & BRADY LLP (I), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 16 -Nov-2016 (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
wa rra nt/c - be issued tgeriN/her inpthe sum AI 00,932.09 .(3)
;rictuAt I t i
Signed: (4)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was orgnally issued,
se-ri
(5)Sbscribedandsworntobeforemethisc2day
UBLIC
My commission expires: • 8444', Notary NANCY Public - D. State BERFiY of Afizon9
MARICOPACOUN'Oeal)
My Comm. Expires Oct SI
Warrant/Check Number VARIOUS WARRANTS (SEE ATTACHED)
(if known) (6)
Original Date of Issue 16-Nov-2016
(if known) (7)
Reason for original issue of Warrant/Check (8):
D Payroll
0 For Services or Goods furnished
Treasurer's refund/payment SATISFACTION OF JUDGEMEHTS•HAFUCOPA courir Y TREASURER WARRANTS (SEEATTACHED)
Li Other:
Warrant 848222 Date Issued 11/16/16 Amount $ 2,852.97
Warrant 853459 Date Issued 03/15/17 Amount $12,155.48
Warrant 853460 Date Issued 03/15/17 Amount $11,950.25
Warrant 853665 Date Issued 03/20/17 Amount $ 2,939,08
Warrant 853785 Date Issued 03/22/17 Amount $ 926.54
Warrant 853786 Date Issued 03/22/17 Amount $ 107.77

TRUST ACCOUNT OF QUARLES & BRADY LLP
WARRANT NUMBER DATE ISSUED AMOUNT
848222 11/16/2016 $ 2,852.97
853459 3/15/2017 $ 12,155.48
853460 3/15/2017 $ 11,950.25
853665 3/20/2017 $ 2,939.08
853785 3/22/2017 $ 926.54
853786 3/22/2017 $ 107.77
GRAND TOTAL $ 30,932.09