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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) RECEIVED DEC 03 20th TO: CLERK OF THE BOARD MAR ICOPA COUNTY CLERK BOARD OF SUPERVISORS FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 12/3/2018 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. #21 Murphy Elementary Cynthia Spade $2,756.31 #21 Murphy Elementary Cynthia Spade $1,361.22 Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (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. CYNTHIA SPADE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 0515 I •t 0 (date)(2) a warrant/check was issued to the above named person/ ntity 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 $2,756.31 .(3) Signed: ttk cAtc9/Le (4) worn to before me this %._.90S-- - day of X61,2t4/„. 20 BARBARA GRACIA j Natty Pubic - ci Arizona / M ornmis on expires: Comet MARICOPA 11551098 Exp. COUNTY Sept 113, 2022 /o (seal) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number 3700040497 (if known) (6) Original Date of Issue 05/31/2018 (if known) (7) Reason for original issue of Warrant/Check (8): ,.:LERK BOARD OF SUPERVISORS Payroll mARICOPA COUNTY 0 For Services or Goods furnished 0 Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (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. CYNTHIA SPADE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about cogiA (date)(2) a warrant/check was issued to the above named person/ ntity i 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 $1,361.22 .(3) Signed: (4) (5) Sub, er orn to befose-me this iday of 20 le . NOTARY PUBLIC F3ARBARA GRACIA I Notay Pubac - State Arizona MARICOPACOUNTY n expires: Com. 0551098 E. Sept 18, 2022 / , (seal) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number 3700088023 (if known) (6) Original Date of Issue 09/21/2018 (if known) (7) Reason for original issue of Warrant/Check (8): CLERK: BOARD OF SUPERVISORS Payroll MARICOPA COUNTY El For Services or Goods furnished El Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999