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INTEROFFICE MEMORANDUM 514aricopa County School-Superintendent's Office TO: CLERK OE VIE (BOACO) FROM: Wiffie Thompson SUBJECT: Affidavits DATE: 11/13/2018 Pase find attached 1 Affidavit/Notice of Cfaim(s)for lost warrants for inclusion on the next avaira hie Ooard agenda -\1 'The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued The original. warrant(s) have had a stop payment done. 11. you have any questions, Aase contact Willie Thompson at 372-1244 or via e-mad at mthompson@mcesamaricopa.gov. Approved Affidavits may be routed back to the Superintendent of School - Finance Division at 4041 N. Central Avenue #1200, ( 12 th Efoor) Thankyou. #44 AVONDALE A.7V -GELIVE SCOJ 1 $564.78 RECEVED NOV 1 4 2018 MARICOPP. COUNTY CLERK BOARD OF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: • 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. Angelique, Scott (1), being first sworn, upon oath deposes and says: —Ranne/Ciaimant On or about 8/21/18 (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/c1;qck be issupd to hi her in t sum of $564.78 .(3) Signed/ if (4) Note: " ;;se attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subspribed and sworn to before me this day of \I)cy..1tvvI\p er 20 t yVIe NC/ARY PUBLIC TYLER ROMERO Notary Public - State ot Arizona My cimmi I sion expires: My MARICOPA Commission COUNTY Expires e January 25, 2022 (seal) Warrant/Check Number 3700073350 (if known) (6) Original Date of Issue 8/21/18 (if known) (7) PROVED It( Reason for original issue of Warrant/Check (8): Payroll - RD OF SL3PERVISORS 0 For Services or Goods furnished ,A COUNTY Treasurer's refund/payment LII Other: 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