09.19.18 REPLACEMENT WARRANT ATTACHMENT.PDF

MARICOPA COUNTY 110AnD OF SUPER YiS9A'S
Department of Finance MARICOPA COUNT Y
301 West Jefferson, Ste 960 2111 AUG -3 API 11 : 52
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: August 3, 2018
To: Clerk of the Board
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.
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: BEDROSIANS

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit! Claim Form
This application is for: 0 Duplicate or 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
paae 2 of this form.
BEDROSIANS (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 issued to him/her in the sum of $ See attachment -(3)
Signed: /41'14x 'arda/n,Wk7 (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) Subscribed and sworn to before me this day of 20
tfi
NOTARY PUBLIC
My commission expires:
(seal)
Warrant/Check Number
(if known) (6) See attachment
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
O Payroll
O For Services or Goods furnished
O Treasurer's refund/payment
EZ1 Other: fCc Jatz-its-A45
Cnecv- ?axi yvve_,#-As.
II IE 1E IJ
AUG 0,9 al8
By

Summary of Unclaimed Funds
350014283 12/9/2014 _ Bedrosians $150.00
350018571 1/26/2015 Bedrosians $100.00
350031048 6/6/2015 Bedrosians $106.00
360000995 7/13/2015 Bedrosians $79.00
360006008 9/8/2015 Bedrosians $52.00
360008599 10/812015 Bedrosians $100.00
360013129 12/7/2015 Bedrosians $100.00
360023223 04/11/2016 Bedrosians $100.00
Total $787.00

A . notary public or other officer completing this
certificate verifies only the identity of the
individual who signed the document to which this
certificate is attached, and not the truthfulness,
accuracy, or validity of that document.
CERTIFICATE OF ACKNOWLEDGMENT
State of California
County of )----/-La 5 ho
On 2/3624? before me,
Date (here insert name and title of the officer)
personally appeared A-frol,„, rike ,
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be
the person (s) whose name (s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed
the same in his/her/their authorized capacity (ies), and that by
his/her/their signature (s) on the instrument the person (s),
or the entity upon behalf of which the person (s) acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the
State of California that the foregoing paragraph is true and
correct.
WITNESS my hand and official seal.
1 • SANDRA COMM. KAY #2138615 KOSLAN m
to tU • gg ,0 t Notary FRESNO Public-California CZT: weivIvi
•‘.1,4,•*. 4,,74C.rz210.4.DEC. 27, 2
Signature Place Notary Seal Above
Signature of No

1. ABCO, STORE NUMBER 422
2. ALCO DISCOUNT STORE339
3. ALL WAYS MOVING STORAGE
4. AMARR GARAGE DOORS
5. CREDIT UNION WEST
6. CUSTOM CYCLE ATV
7. EVERGREEN HARDWARE&ELECT
8. F F MAIL BOXES EMPORIUM
9. HOUSE DOCTORS
10. IAMI LLC
11. SBF LLC
12. SOUNDS LIKE MUSIC INC
13. SUNFLOWER MARKETS, STORE
14. SUNOVATIONGMBH CODALE WH
15. TRS HOME FURNISHINGS
16. WILCOCK ASSOCIATES

Application for a Duplicate or Stale-Dated arrant/Check
Affidavit/Claim Form
This application is for: 0 Dup irate 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
Oak Point Partners, LLC, cage 2 of this form.
S/I/I Flernir$ Post Confirmation Trust (1), being first sworn, upon oath deposet and says: -
NamodCimment -
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 issued to him/her in the sum of $ See attachment .(3)
Signed: Oak Point Partners, LLC. by. Paul Standfield Vice President, Finance (4)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was •orionally issued
(5) Subscribed and sworn to before me this day of ?qua s -r 20 tif
NOTARY PUBLIC
Official Seal
Dee M Bender
My co mission expires; Notaty Public State of Illinois
3 Act pa, My Commission Expinat _01130/2020
Warrant/Check Number
fif known) (6)
Original Date of Issue
Reason for original issue of Warrant/Check (8):
LI Payroll
0 For Services or Goods furnished
ED Treasurer's refund/payment
Other:
ABCO VIC ID 15083,15041& 15062

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360005984 9/8/2015 ABCO, STORE NUMBER 422 40.68
00360005985 9/8/2015 ABCO, STORE NUMBER 425 $47.57
00360005986 9/8/2015 ABCO, STORE NUMBER 427 $61.45
Total $149.70

Appli• rt for a Duplicate & le-Dated rrant/Check
davit/Claim Form
This applitiov is fort t 1 Dupimate_ or E Stale-D_ated tdeorations 011 paLW 2
•STATE OF ARIZONA Nae,. Nunqb&s on tits form
COMM! OF WR1COPA nurnbws tht,k. linslaverion si-i-ptviAlioh Is
t;q.2 of tis. form.
(1), beim first sworm uck--)al oath deps and salfs:
V.\
On or about •See ailed-in:Lew (ciate)(2) a Warrant/check was issued to
above named personlentity in the amount as stated below. Stith warrantIcheck was
either never received or was •subsequendy inadvertently lost or dez,--Voyed and there is
no reasonable probaWky of it 6.6bg found or presented for payment, or it - Aia.5 not
prese.nted for payment within one yr after the date of issuanc...e..
Therefore, under penai of perjury, claimant hereby affirms that this dairo is correct
and the amount shaA s due and ovifing, and the applicant requests that a repiac.,~ment
viat ant/died< b ber in sum of $ See attack4aent .(3)
(4)
copy of the wreiran0.thk ?f ari4 /.5.1e aria/or airy offier
evidence mate z .1V/CheCk was offaiii
(51 Subs
NOTARY PUBLIC DEBORAH CHA SPYCH
Notary Pubko
My t'ornmission expires:: My Commission State of [Delaware Expires On
EIL,0415 October 20, 2019
Warrant/Check Nur
anal-mra (6)
Orighlal Date of Issue
m
Reason for oriainat issue of Wanant 1Cieck (8)
Payroli
LI For Services or Goods furnished
CJ Treasurers refundjpaymerit
Other:
co DISOMNT STORS.',139 VIC ID 225s4

Seminary of Unclaimed Funds
Frotioil
00360000979 7/13/2015 ALCO DISCOUNT — STORE339 ..$ 14Z4
00360019932 3/3/2016 ALCO osco ti NT STDRn39 $40-00
•
0060028309 5/7/2016 ALCO iD4SCOUNT „ STQRE339 $90;06
Total $242,14

Date: August 1, 2018
ALCO Liquidating Trust
27 Crimson King Drive
Bear, DE 19701
To: County of Maricopa
Attn: Patricia Cordova, Bureau Chief; Diversion Program/Check Enforcement Program
Re: Restitution Payments for ALCO Stores, Inc; (formerly known as Duckwa(l-ALCO Stores, Inc.
and Duckwall Variety Stores) and ALCO Holdings, LL.C.
Any bad check and/or restitution payments for the former ALCO Stores, Inc (formerly known as
Duckvvall-ALCO Stores, Inc. or Duckwail Variety Stores) or ALCO Holdings LLC should be issued to "ALCO
Liquidating Trust" and sent to the attention of Anthony M. Sacculio, Esq., the Liquidating Trustee for the
ALCO Liquidating Trust, the successor in interest to ALCO Holdings, LLC and ALCO Stores, Inc.
(collectively, as debtors-in-possession, the "Debtors'). On October 12, 2014, each of the Debtors filed a
voluntary petition under Chapter 11 of the U.S. Bankruptcy Code; case 14-34941. On July 22, 2015, a
plan of liquidation became effective and all of the remaining assets of the Debtors were transferred into
the ALCO Liquidating Trust for final liquidation, at which time all management and oversight
responsibilities transferred to the Liquidating Trustee.
Supporting documentation enclosed is a WY for ALCO Liquidating Trust and the (ALCO) Effective
Date Notice of this transfer from the Debtors to ALCO Liquidating Trust. Further bankruptcy
information for Ala) Stores, Inc. and Alm Holdings, LLC; can be found at
littpsjicases,primeclerLcom/alco/Horne - Inclex
If you have should have any questions, please contact the Liquidating Trustee at (302) 643-9175
or via email at dspych@sacculloconsulting.com .
Sincerely,
Mary S. Petz
(On behalf of the Liquidating Trustee for the ALCO Liquidating Trust)

•
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Case 14-34941-sgill Doc 1260 Filed 07/22115 Entered 07/22/15 11:02:10 Page 1 of 2
Vincent P. Slosber„ State Bar No. 00785480 Thomas R. Califa..no (admitted pro hoc vice)
vince.slushen@dlapiper.com thomas.califano@dlapiper.com
Andrew ZahnEer, State Bar No. 24063944 Daniel a Egan (admitted pro hoc vice)
andrew.zol inger@diapiper.com daniel Lc-gang:A lapip er. corn
DTA. PIPER UP (US) DEA PIPER LEP (US)
1717 Main Street, Suite 4600 1251 Avenue of the Americas
Dallas, Texas 75201 New York, New York 10020
"Felephorie (214) 743-4500 Telephone: (212) 335-4500
Facsimile: (972) 813-6267 Facsimile: (212) 335-4501
Attorneys for the Debtors arid Debtors in Possession
TN THE UNITED STATES BANKRUPTCY COURT
FOR THE _NORTHERN DISTRICT OF TEXAS
DALLAS DIVISION
in re:
Case No: 14-34941
ALCO STORES, INC., et al. 1
Chapter 11
Debtors. Jointly Administered
NOTICE OF ID ENTRY OF ORDER CONFIRMING THE DEBTORS'
FIRST AMENDED PLAN OF LIQUIDATION PURSUANT TO
CILAPTER II OF THE BANKRUPTCV CODE AND LI1) ET=LfELL)A. 1..21..f.,
PLEASE TAKE NOTICE that an order (the "Confirmation Order") of the Honorable Stacey G.C.
Jernigan, United States BankTuptcv Judge for the Northern District of Texas, approving the Debtors First
Amended Plan of Liquidation Pursuant to Chapter II of the Bankruptcy Code, dated as of February 18,
2015 [Dld, No, 957] (including all exhibits thereto and as the same may be further amended, modified or
supplemented from time to time, the "Plan"), was entered on June 3, 2015 [Dkt. No. 11901. Unless
otherwise defined in this notice, capitalized terms used herein shall have the meanings ascribed to them in
the Plan and the Confirmation Order.
PLEASE TAKE FURTHER NOTICE that copies of the Plan, the Confirmation Order, and other
related documents may be obtained by (i) accessing the website maintained by the Plan Debtors' Claims
Agent, Prime Clerk, available at http://cases.primeclerk.comialco/, or (ii) accessing the Bankruptcy
Court's website at http://www ,txnb.useourts.gov . Note that a PACER password is needed to access
documents on the Bankruptcy Court's websn.e. Any party in interest wishing to obtain hard. copies of the
Plan, Confirmation Order, and other related documents may request such copies by (1) contacting Prime
Clerk at (844) 794-3478, (ii) contacting Sherry Faulkner at DLA Piper LLP (US) at (214) 743-4565, or
(iii) contacting the Office of the Clerk of the Court, Earle Cabell Federal Building, 1100 Commerce St.,
Rm. 125, Dallas, TX 75242.
The Debtors in these chapter 11 cases, along with the last four (4) digits of their taxpayer identification
number, are ALCO Stores, Inc, (1080) and ATCO Holdings. LLC (0364). The mailing address of the Debtors, solely
for purposes of notices and communications, is ALCO Stores, inc., 751 Freeport Parkway, Coppell, Texas 75019.
EASTU02152467.1 1

Case 14-34941-sgal Doe 1260 Filed 07/22/15 Entered 07/22/15 11:02:10 Page 2 of 2
PLEASE TAKE FURTHER NOTICE that the Effective Date of the Plan occurred on July 22,
2015,
PLEASE, TAKE FURTHER NOTICE that the Plan and its provisions are binding on the Plan
Debtors, the Liquidating Trustee, the Liquating Trust, the DIP Lenders, and any holder of a Claim against
or Interest in the Plan Debtors, as provided in the Plan.
PLEASE TAKE FURTHER NOTICE that, as set forth in the Confirmation Order, the deadline to
file a request for payment of an Administrative. Claim, or a Proof of Claim related to the foregoing, must
have been or be filed with the Bankruptcy Court on or before thirty (30) days after the Effective Date
(unless such request for payment or Proof of Claim has already been filed with the BankTuptcy Court).
PLEASE TAKE FURTHER NO'lICE that, except as otherwise provided in orders entered by the
Bankruptcy Court, all Proofs of Claim with respect to Claims arising from the rejection of Executory
Contracts or Unexpired Leases, if any, must be filed with. the Bankruptcy Court and served on counsel to
the Plan Debtors and the Liquidating Trustee on or before the date that is thirty (30) days after service of
this Notice.
Dated: July- 22, 2015 DLA PIPER LAY (US)
Dallas, Texas
By: A/ Vincent R Slusher
Vincent P. Slusher, State Bar No. 00785480
vince.slusher@dlapiper.com
Andrew Zollinger, State Bar No 24063944
andrew. zol i iriaer(iNlapiper.cotri
DLA Piper LLP (US)
1717 Main Street, Suite 4600
Dallas, Texas 75201-4629
Telephone: (214) 743-4500
Facsimile: (214) 743-4545
Thomas R. Califon° (admitted pro bac vice)
thomas.ca1ifone0,dlapiper,com
Daniel G. Egan (admitted pro hew vice)
daniel.egan(iNlopiper.com
DLA Piper 1,LP (US)
1251 Avenue of the Americas
New York, New York 10020-1104
Tel: (212) 335-4500
Fax: (212) 335-4501
Attorneys for the Debtors and
Debtors in Possession
EASM02152467.

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
gable 2 of this form.
itA )q))1,11, (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about See attachment (clate)(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 issued to him/her in the 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 ofiginally issued
(5) Subscribe nd sworn to
NO ARY PUBLIC
My commission expires:
aCr- Of) (90d- / 25keL
'71C0?
0.#1,Trrrrees1:__
Warrant/Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
E Payroll
ok For Services or Goods furnished
Treasurer's refund/payment _
El Other:
ALL WAYS MOVING STORAGE VIC 1D22274

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360008587 10/8/2015 ALL WAYS MOVING STORAGE $50.00
00360013119 12/7/2015 ALL WAYS MOVING STORAGE $100.00
00360018105 2/9/2016 ALL WAYS MOVING STORAGE $20.00
00360023209 4/11/2016 ALL WAYS MOVING STORAGE $40.00
00360025384 5/4/2016 ALL WAYS MOVING STORAGE $18.74
Total $228.74

19p9,3
Application for a Dupl cats or Stale-Dated Warrant/Check
Affidavit/Claim Form
This applicatio is for Chiplicate or ILI Stale—Dated• (definitions are on p, -Ae 2)
STATE. OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF 1V1ARtCOPA I numbers onthe Instruction sheet which is
Dace 2 of this-form,
PIlit-rni..:: csv,yve J1), being first sworn, upon oath deposes and says:
Claiman! Deldolavt...0
On or about ....et attachment . (datt)(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/cheek. be issued to him/her in the sum of $ ,ee.attachtacnt 489.0.5q .(3)
Signed.: (42)
Note; Please attach a copy of the warrant/check if available and/or any other
.evidence that a warrant/check was onOinally Issued,
worn to before me this q41', day of n 1,1,41 20 ir
CHERYL _HUNT
Notacy PuGlic, North Carolina
Guilford County
My Commission Expires
May26,2021
Warrant/Check Number
knowp)i§_l OD,3 69 0oosqq
Original Date of Issue
if known) (7) 00081Q421.5
Reason for original issue of Warrant/Check (8):
El Payroll
E. For Services. or Goods furnished
0 Treasurer's refund/payment
CV-Other:
AMARR GARAGE DOORS VIC ID 22010

August 09, 2018
To: Maricopa County Attorney's Office
301 W Jefferson, 8th Floor
Phoenix, AZ 85003
Re: Warrant #00360005994 $856.59 09/08/2015
Roger Hoskinson/East Valley Ent Inc Check #1295
To Whom It May Concern:
My name is Christine Wall. I am the Credit Analyst for Amarr Garage Doors at ourE
corporate office in Winston Salem, NC.
The original warrant check issued by you was never received by us due to wrong
address. Our location in Phoenix AZ had moved.
Please reissue the check and mail to our corporate office at:
Attn: Christine Wall
Entrematic/Amarr
165 Carriage Court
Winston Salem, NC 27105
Thank you.
Christine Wall/Credit Analyst -6.4t6),
Entrematic/Amarr
165 Carriage Court
Winston Salem, NC 27105
Phone: 800-903-4624 165 Carriage Court
Winston-Salem, NC
27105-1326
Ph 336 744.5100
amarr.com

q
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L FARGO V#V,LLS OF TO
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LO
MesaAZ 1225 Wells EAST
www.wel , W. Fa 2959
85 /2t S
isfa Guactalupe rgo13-ars'OrO PEN EAST VALLEY
k4m V MESA
el .Z.L;W NMI V E
S27,131:01161-1E:4YAIL L 1.1° ON EY
5202
inE DOOR TERPRISES,
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•

Summary of Unclaimed Funds
VVarrant ft Issue [?ate VeritiorjItOnie Warrant Amount
00360005994 9/8/2015 AMARR GARAGE DOORS $856,59

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 Duplicate or 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
Dale 2 of this form.
(1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about See attachment (date)(2) a warrant/check was issued tq the
above named person/entity in the amount as stated below. Such warrant/checl was
either never received or was subsequently inadvertently lost or destroyed and th re 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/checJ be issued t9 him/her in the sum of $ See attachment .(3)
Signed: . (4)
Note: Please attach a copy o7the warrant/check if available and/or any `Fther
evidence that a warrant/check was ofiginally issued
(5) Subscribed and sworn to before me this
NANCY A,
My commission expires: Notary Public - Arizotei
Expires tani
Warrant/Check Number
if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
E Payroll
CI For Services or Goods furnished
0 Treasurer's refund/payment
CI Other:
CREDIT UNION WEST VIC ID 24632

CORPORATE RESOLUTION
State of Arizona
) SS
County of Maricopa )
THIS IS TO CERTIFY THAT at a meeting of the Board of Directors of Credit Union West, a
corporation organized and existing under the laws of the State of Arizona, duly called on June
26, 2018 the following resolution was adopted and the same has not been revoked.
RESOLVED THAT Robert W. MacGregor, as Chief Executive Officer, Karen Roch, as
President, Pamela L. Chan, as Chief Financial Officer, Scott R. Grundy as Chief Information
Officer, and Robert Birr, as Chief Lending Officer of this corporation, or any of them are
hereby authorized and empowered for and on behalf of and in the name of this corporation and
on such terms and conditions and in such amounts as they see fit.
To make, execute and deliver any and all instruments, including but not Limited to, Contracts,
Escrow Instructions, Deeds, Notes, Deeds of Trust, Mortgages, Trust Agreements and all other
instruments necessary to, or in connection with, the purchase or sale of, or the encumbrance of,
real and personal property.
IN WITNESS WHEREOF, the Chair, Board of Directors of this corporation has hereunto set
their hand officially this June 26, 2018.
Luis E. Generreau,
Chair, Board of Directors
Subscribed, Sworn to and Acknowledged before me this June 26, 2018 by Luis E. Gendreau,
as Chair, Board of Directors of Credit Union West, a corporation of the State of Arizona, on
behalf of said corporation.
JAIME BURT
Notary Public - Arizona
Maricopa County
tary Public Expires 03/24/2021
Commission Expires: Si 24 I zsiz,

Summary of Unclaimed Funds

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 Duplicate or Ei 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
me 2 of this form
(1), being first sworn, upon oath deposes and says:
ameieiaimn
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 issue h the sum of $ See attachment .(3)
Signed: (4)
Note: Please attach /copy of 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 (0 day of at, 20 k
NOTARY PUBLIC
My commission expires:
7. Z7. Z 6 seal)
Warrant/Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
O Payroll
0 For Services or Goods furnished
• Treasurer's refund/payment
O Other:
cst54-0 yn C ycl e- ;Ro33cot

Summary of Unclaimed Funds
$30.00
00360003101 CUSTOM CYCLE ATV $15.00
L00366666030' ..::CUSTOM :CYCLE AN $15.00
I 00360011156 11/10/2015 CUSTOM CYCLE ATV $15.00
I• =
003.60013151 12/7/2(45 : CUSTOM CYCLE AN $15.00
00360015378 1/6/2016 CUSTOM CYCLE AN $30.00
60360023243 . 4/11/2016 CUSTOM CYCLE ATV $45.00
•
1 00360025413 5/4/2016 CUSTOM CYCLE AN
Total

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: El Duplicate or E) Stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MAR1COPA numbers on the Instruction sheet which is
Daae 2 of this form.
(1), being first sworn, upon oath deposes and says:
Name/Uaimant
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/cbetij be issued to himi.ber in the sum of $ See attachment .(3)
Signe (4)
Note: Please attach a of the warrant/check if available and/or any other
evidence that a warrant/check was ofigtMally &sued.
) Subscribed and sw n to before me this
kfsnoL9L6
My coimmi4on expires:
og 0 Ki zo z-b
Warrant/Check Number
if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
E Payroll
ix For Services or Goods furnished
E Treasurer's refund/payment
E Other:
') • 'jfti
EVERGREEN HARDWARE & ELECT VIC ID 9460

Summary of Unclaimed Funds
Warrant If Issue Date Vendor Name Warrant Amount
00360008629 10/8/2015 EVERGREEN HARDWARE&ELECT $76.95
00360018133 2/9/2016 EVERGREEN HARDWARE&ELECT $417.10
00360019971 3/3/2016 EVERGREEN HARDWARE&ELECT $105.20
00360028334 6/7/2016 EVERGREEN HARDWARE&ELECT $171.60
Total $770.85

(.1 0 110.000 .....;+- s WW1 < Prnve...•II ratlme... ...•••.•••••I
wre MX
c)
according the
to
that as
only
certifies and Commission.
It it/00:474
specifically audit.
43-1151.
Inc. 43, Corporation
Withdrawal Section Title IDENTIFICATION subsequent
and numbers: 86-0368734 ,07-219414-P 86-036873-4 602-7164234 . to the
Compliance Electric, andior 42 of.any 2013
12-1110 Title findings ,lytinlinez 30, WWW.A7n011gov compliance
under identificatien/licease : • a . the Ana Ivtanager May z.- of
& Section due • to
or times certificate
Statutes all add •
of paid types . ;and the
Hardware itsed and Number of
tax
Arizona filed . License conditionally submission
has desetibed
Dissolution to taxpayer Identification 'tax • fOr
Certificate pursuant following iniade 106,,
Evergreen named Privilege License responsible
issued lmpIoyer Certification Electric, .
is above TYPE .8c : Is
Compliance the Federal Transaction Withholding This fiardmrare Lough Avenue 85021 taxpayer
TAX
records, Donald 7th AZ The
for of In: Evergreen N.
• depettment issued Attn: 8702 Phoenix, NOTE:
Certificate
This to

AZ Cor . Commission
AZ CORPORATION COMMISSION HIll 11111 unlli III II III LUll III 11111 tIM 11111
FILED
JUN 0 6 2013
FIE N ° 1°2' AA1
WM= DO mar WIECIE ADOVE TIES LINE; ;IMAMFOR AC c LTRE ONLY.
ARTICLES OF DISSOLUTION
Read the Instructions 0221
I. ENTITY NAME - give the exact name of the corporation as currently.shown in A.C.C. records:
EVERGREEN HARDWARE & ELECTRIC, INC.
2« A.C.C. FILE NUMBER: 01224987
Find the A.C.C. Me number on the upper corner of Med dixuments OR on our website att trity://www.atcr..uoviDivisiorisiCurporations
3. DATE OF INCORPORATION: - -41-30 /-7C117
4. DATE ON WHICH DISSOLUTION WAS AUTHORIZED:
5. TAX CLEARANCE CERTIFICATE (Certificate of Compliance) - check only one box (see
Instructions CO221 for more information):
This dissolution WILL require a Certificate of Compliance from the Arizona
Department of Revenue because either the for-profit corporation has commenced
business or issued shares, or the nonprofit corporatiOn has commenced activities, has
members, or has members entitled to vote on dissolution..(Noft - signature must be by
officer or Chairmen of the Board.) If you check 5.1, continue with number 6 or number 7.
5-2 0 This dissolution WILL NOT require a Certificate of Compliance from the Arizona
Department of Revenue because either -the for-profit corporation has not commenced
business or has not issued shares, or the nonprofit corporation has not commenced
activities, does not have members, or does not have members entitled to vote on
dissolution. (Note - signature must be by Initial director, nonprofit director, or
incorporator.) If you check 52, skip numbers 6 and 7 and go to number 8 or number 9.
6. FOR-PROFIT CORPORATIONS THAT CHEMED NUMBER 5.1 - check the appropriate box
concerning approval of the dissolution and follow instructions (see the Instructions CQ221for
Information about voting groups):
0 Approved by incorporators or board of directors without shareholder action, and
shareholder approval was not required or no shares have .been issued- go to Signature
section.
123 Approved by shareholders but not voting groups - complete number 6.1, then go to
Signature section.
Approved by shareholders and voting groups - complete numbers 6.1 and 6.2, then go
to Signature section.
0 Approved by voting group(s) only - corriplete number 6.2 then go to Signature
• section.
6.1 Shareholder approval (ail blanks must be filled In):
Total erilitled votes to be for VotEeo approval in favor of dissoluton that were suffnt Votes against
cast dissolution
,
-&-''
COZaesii
foir. 2010 iiatmoo Carpossiion Commission - osparniami Woke
he 1oti2

Application for a Duplicate or Stale-Dated Warrant/Check
AffidaVit/Claim Form
This application is for: 0 Duplicate or 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
oaoe 2 of this form.
(1), being first sworn, upon oath deposes and says:
NamettAimant
On or ab t 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 neverrreceived 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 dat,e 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 issuedito him/her in the sum OWee attachment .(3)
Si ned:
Noy: Please attach a copy of the warrant/check if available and/or any other
eVidence that a warrant/check was originally issued.
(5) Subscri* and sworn to before me this (01'-‘- day of _Aa4 1--" 20 (8
NOTAR OFFf C:AL cx,7,711.
SSE WEEDMAN
My commission expires:
797//7/62/0 ',trlira-Li NOV. 01, 2 seal)
Warrant/Check Number
if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
Payroll
El For Services or Goods furnished
E Treasurer's refund/payment
121 Other:
F F MAIL BOXES EMPORIUM VIC ID 21741

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360025417 5/412016 . F .F MAIL BOXES EMPORIUM $241,63

identification number 1. Wages, tips, other 2. Fed income tax withheld 3_ Social security wages
b. Employer compensation
41-0760000 OMB No. 1545-0008 17,417.63 2,129,98 17,417.63
4. Social security tax 5. Medicare wages 6. Medicare tax withheld
0, Employer's name, address, and ZIP code withheld
United States Postal Service 1,079.89 17,417.63 252.56
Minneapolis Accounting Service C.erner 9, Advanced EIC 10. FSA total contributions 10a. FSA dependant core
2825 Lone Oak Pkwy
Eagan MN 55121-9611 NONE NONE NONE
lob, FSA health care 14, Employee cordrib (TS P) 15. Pear year TSP contith
d. Employee's social security number
.
526 -78 - 5169 NONE NONE NONE
31. TCOL allowance 32. Employee business 33. Taxable empi business
e. Employee'e name, addrees, and ZIP code Rnance No expense expenses '
J M HURLBERT FERRIN 03-6364 NONE . • NONE NONE
2738 E WINDROSE DR 34. Pension plan coverage 35. Imputed income life ins ' 36. Misceilaneous '
PHOENIX AZ 85032-6933
YES 208.51 NONE
37. Pre-tax HEI 38, Occupation tax
withheld
107,00 NONE
,
16. Employer% State ID No 17. Staterterr. gross 18. Slate inc. tax 19. Locality name 29, Localwages 21. Local tax withheld
wages withheld
410760000 17,417.63' 377.75 NONE NONE NONE
.. .. AZ ]
.1 el Wage And Tax 1999 This amount is included in Box 1 Department of the Treasury-Internal Revenue Service
FOFTMW .4 Statement
Copy 2 To Be Flied With Employee's State, Cftr, or Local Tax Return

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit! Claim Form
This application is for: EI Duplicate or Ei 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,
CL5-0,' (1), being first sworn, upon oath deposes and says:
Name/Okairnant
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 issued to him/her in the sum of $ See attachment .(3)
Signed: (4)
Note: Please .iir-ach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Subscribed and svy.qrn to before me this 2 ( /e4 day of jet.A. 20 /a
NOTARY PUBLIC
Warrant/Check Number
(if known) (6) 003(o0oi316{ 003(0obig 0-13
Original Date of Issue
(if known) (7) 11,1-76
Reason for original issue of Warrant/Check (8):
CI Payroll
efg* For Services or Goods furnished
El Treasurer's refund/payment
E3 Other:
HOUSE DOCTORS VIC ID 175306

Summary of Unclaimed Funds
Warrant If Issue Date no/ arrant. Amount
00360013164 12/7/2015 HOUSE DOCTORS $100.00
00360018143 2/9/2016 HOUSE DOCTORS $20,00
Total $120.00

AUG 0 3 1018
MARVELOUS ENTER
9
Dba: East Valley Handyman
897 E. Reliant St. Gilbert, AZ 85298
480-782-8484
ROC 209849
July 31, 2018
To: Marieopa County Attorney
Re: Applicant for Duplicate check
I have attached the notarized copy of the claim form for issuing replacement checks. Our corporate name
of Marvelous Enterprises has not changed, nor our contractor's license number, however has our Dba changed
from House Doctors to East Valley Handyman.
Thank you,
Craig Margulis
President

Application for for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 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.
L_La (1), being first sworn, upon oath deposes and says:
Nan
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 issued to him/her the 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) Subscribed and sworn to before me this U day of 2O1b .
LAJ WHITNEY HUGH
1 Al
NOTARY PUBLIC LAPEER COUNTY
MY COMMISSION EXPIRES 08-31-2023
ACTING IN THE COUNTY OF:
Liinfon (seal)
Warrant/Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
O Payroll
E For Services or Goods furnished
E Treasurer's refund/payment
pther: QA-TC.;() eiq 41)4Y AID -5-
IAIVII UC VIC ID 186844

Summary of Unclaimed Funds
Warrant# Issue Date Vendor Name Warrant Amount
00360001035 7/13/2015 IAMILLC R/b`ri) 146-1— .6j3+16-: $270.00
rg y 77o-Es-6
0036000311 8/5/2015 IAMI LLC $260.00
€
9/8/2015 IAMILLC $250.00
0036000863 10/8/2015 IAMILLC $250.00
003600111n* 11/10/2015 iArvl I LC $250.00
12/7/2015 IAMI LLC $250.00
00360015391 1/6/2016 IAMILLC $250.00
C
00360018144 2/9/2016 IAMI LLC 02S' $250.00
3/3/2016 IAMI LLC rcZ $250.00
4/11/2016 IAMI LLC $250.00
0036002543 5/4/2016 IAMI LLC $250.00
- 00360028342 6/7/2016 IAMI LLC $250.00
Total $3,030,00
L42r__If

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 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
ciaae 2 of this form.
1 t
(1k (1), being first sworn, upon oath deposes and says:
ame aimant{
41tiJ 2o t'
On or about See attehme t (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/c/hlk ..11.(111 the sum of $ See attachment 07(Sga, .(3)
Signed: (4)
Note: Please''Vtach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally &sued.
(5) Subscribed an sworn to before me this 1 i 141 day of 0,30st 20 6
NOTARY PUBLIC loAe 12.e. fillarcii-
frIevq(4% (00m-5 A L DANIELLE REINHARDT
Notary Public, State of Arizona
My commission expires: Maricopa County
9etnixv-1 8 ( gati-c) My January Commission 18, 2022 Expires seal)
Warrant/Check Number
if known) (6) 6C) 3 (000 (2 33fAs2
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
E Payroll
K"For Services or Goods furnished 4---ILtk-ADIA A Jre
1=1 Treasurer's refund/payment
Other:
SBF LLC VIC ID 195944

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360023306 4/11/2016 SBF LC $2,882.00

-J e UN %AI 4.0 I
Search Date and Time:
8/7/2018 10:45:01 AM
Entity Details
Entity Name:
SBF LLC
Entity ID:
L16026728
Entity Type:
Domestic LLC
• Entity Status:
Inactive
Formation Dater
5/14/2010
Reason for Status:
Unavailable
Unavailable
Approval Date:
5/18/2010
Status Date:
8/8/2013
Original Incorporation Date:
5/14/2010
Perpetual Privacy Policy (http://www.azcc.gov/Divisions/Administration/Privacy.asp) Life Period:
I Contact Us
(http://www.azcc.gov/divisions/corporations/contact-us.asp)
Principal Information
Date of Taking Last
Title Name Attention Address
Office Updated
ANTHONY 7412 W MORROW DR,
Mcmbcr 5/14/2010 5/18/2010
MATTIOLI GLENDALE, AZ, 85308, USA
Privacy palicyr(http://wwiy.azcc.gov/Divisions/Administration/Privacy.asp) I Contact Us
(http://www.azcagov/divisions/corporations/contact-us.asp)

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 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.
David Wiggs (1), being first sworn, upon oath deposes and says:
Name/Claimant
See attachment
On or about (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 issued to,him/her in the sum of $ See Attachment .(3)
Signed: (4)
Note: Please attach a copy of thewarrant/check if available and/or any other
evidence that a warrant/check was originally issued,
(5) Subscribed and sworn to before me this day of 41-V,,, 20
NOTARY PUBLIC
-----
My commission expires: CARLOS DOMINGUEZ
1 -7 67 Notary Public - State of Arizona , eal)
MARICOPACOUNTY
Mv Cornmiesion Expires
Warrant/Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
0 Payroll
E For Services or Goods furnished
E Treasurer's refund/payment
LI Other:
SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc
Revised April 2015 A.R.S. 11-632 & 11-644
500-NDS L. mtits\c,INC \ILG 1115t) 34.10

Summary of Unclaimed Funds
00360028375 6/7/2016 SOUNDS LIKE MUSIC INC $400.00
Total $700.00

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: El 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
page 2 of this form_
Ac11-P/1/ F471/1L- (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 issued to him/her in the 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) Subscribed and sworn to before me this 211 44, day of ilitiop 20k
Notary Public State of Arizona
My commission expires: Maricopa Natasha Tofu County
3,24. 427 My Commission Expires 03/24/2019 (seal)
Warrant/Check Number sEEI A -ri-ittimr/ui
(if known) (6)
Original Date of Issue
(if known) (7) EE A 1-74(.,Hmf /1/
Reason for original issue of Warrant/Check (8):
O Payroll
For Services or Goods furnished CK0CE I RI non 9 7 71
▪ Treasurer's refund/payment
E Other:
SUNFLOWER MARKETS VIC ID 24168,24167 & 25162

Summary of Unclaimed Funds
Warrant 14 Issue Date Vendor Name Warrant Amount
00360011202 11/10/2015 SUNFLOWER MARKETS $14.07
00360003152 8/5/2015 SUNFLOWER MARKETS $14.56
00360006083 9/8/2015 SUNFLOWER MARKETS $75.82
00360006082 9/8/2015 SUNFLOWER MARKETS $168.59
00360008670 10/8/2015 SUNFLOWER MARKETS $15.67
00360008669 10/8/2015 SUNFLOWER MARKETS $19.28
00360011203 11/10/2015 SUNFLOWER MARKETS $60.92
00360013186 12/7/2015 SUNFLOWER MARKETS $18.63
00360015422 1/6/2016 SUNFLOWER MARKETS $45.38
00360018181 2/9/2016 SUNFLOWER MARKETS $34.20
00360023315 4/11/2016 SUNFLOWER MARKETS $3.67
00360028381 6/7/2016 SUNFLOWER MARKETS $66.21
Total $537.00

"3-rearthy Living For Less!"
Friday, August 24, 2018
The' Maricopa County Attorney' Office
Check Enforcement Program
11 W. Jefferson St, 2nd Floor
To whom it may concern:
The purpose of this memo is to provide the authorization for individuals to sign the Application for a
Duplicate or State-dated Warrant/Check Affidavit/Claim Form ("The Form"). Sunflower Farmers Markets,
LLC ("Sunflower") is ultimately 100% owned by Sprouts Farmers Market, Inc. ("Sprouts"). I hereby declare
that I, Linda Larnbson, am the Senior Director of Tax for Sprouts, and I authorize the following individuals
to sign The Form:
Bradley Lukow, CFO
Robyn Arne11 Brenden, VP - Controller
Linda Lambs on, Senior Director of Tax
Rajat Wadhera, Tax Manager
Aaron Fathe, Tax Analyst
Additionally, I would like to provide a statement for the reason that the original check/warrant was not
presented for payment. We have had turnover in our Accounts Receivable / Accounts Payable department
over the past years. It is quite likely that the checks were lost or misplaced.
Please re-issue the restitution check and mail it to my attention at the following address:
5455 E High St, Ste 111
Phoenix, AZ 85054
Please email me if you have any questions at LindaLambson@Sprouts.com .
Sincerely,
Linda Latnbson,
Support Office: 5455 E, 3-figh St., Suite in, Thoenix, AZ 85054 480-814-8016 —Fax: 480-814-8017
irww.Sprouts.com

Application for a Duplicate o Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for 0 Duplicate or 0 Stale-Dated (definitions are on page 2)
STATE 0 F ARIZ° NA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the instruction sheet which is
SUNOVATION / Heribert Ley Pacie 2 of this form
(1), being first sworn, upon oath deposes and says:
Name/Glatment
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 dile and owing, and the applicant requests that a replacement
warrant/check be issued to/him/her the sum of $ See attachment 1,650.00 $ .(3)
"
Signed: (4)
Note: Pkase attac a copy of warrant/check if available and/or any other
evidence that a wan- nt/check vvas "ginally issued
(5) Subscribed and sworn to before me this day of 20 '1,3
(.L,1•4,,)
NOTARY PUBLIC
My commission expifest
seat)
Warrant/Check Number
(if known (6)
Original Date of Issue
Of known) (7)
Reason for original issue of Wan-ant/Check (8):
O Payroll
O For Services or -Goods furnished
O Treasurer's refund/payment
p Other:
SUNOVATION GMBH VIC 11)24200 By

Summary of Unclaimed Funds
00360001066 7/13/2015 SUNOVATIONGMBH CODALE WH $150.00
00360006084 9/8/2015 SUNOVATIONGMBH CODALE WH $300.00
00360011204 11/10/2015 SUNOVATIONGMBH CODALE WH $150.00
00360013187 12/7/2015 SUNOVATIONGMBH CODALE WH $150.00
00360015423 1/6/2016 SUNOVATIONGMBH CODALE WH $150.00
00360018182 2/9/2016 SUNOVATIONGMBH CODALE WH $150.00
00360020038 3/3/2016 SUNOVATIONGMBH CODALE WH $150.00
00360023316 4/11/2016 SUNOVATIONGMBH CODALE WH $300.00
00360028382 6/7/2016 SUNOVATIONGMBH CODALE WH $150.00
Total $1,650.00

1 1 8 5
File-No. /2018/K
mb
I hereby certify that the document overleaf was signed in my presence by
Mr Heribert Ley,
Diplom Betriebswirt (FH),
born on 19. September 1961,
living in 51519 Odenthal, Wilhelm-Leuschner-Weg 4,
identified by his official identity card,
acting on behalf of SUNOVATION Produktion GmbH, Glanzstoffstraf3e 21, 63820 Elsenfeld
(Germany), as this company's director (Geschaftsfahrer).
Upon my inspection of the commercial register on 22 nd of August 2018, I further certify that
SUNOVATION Produktion GmbH is registered with the Municipal Court of Aschaffenburg -
Commercial Register - under No. HR13 12571 and that Mr Ley is entitled to act individually as
this company's legal representative.
And I do herby further certify,
that the aforesaid Corporation is duly incorporated;
that it is in good standing under the laws of the Federal Republic of Germany;
that it has a legal corporate domicile is Elsenfeld;
so far as the Commercial Register show.
Obernburg a. Main, Bavaria, Germany ignithi, l'2" of August 2018
1J847D

SLINOVATION Produlction GmbH - GlanzstoffstraBe 21 - 61820 Elmanfold
The Maricopa County Attorney's Office
Check Enforcement Program
Att. : Patricia Cordova
301 W. Jefferson, 8th Floor
Phoenix, AZ 85003
USA
08/22/2018
Delivery of the affidavit signed in the presence of a notary
Sunovation Produktion GmbH
Dear Patricia
Please find enclosed the required affidavit signed by our CEO, Mr. Heribert Ley, in the presence of
the notary.
For further Information or question, please contact us.
Kind regards
VATION Prociuktion
Gienzstoffstra8e
[1,63820' Elsenfeld 21
SUNOVATION ProduktIon GmbH Bankverbindung:
Glanzstoffstrafie 21 Geschaftsf0hrer: Raiffeisenbank Obernburg eG
D-63820 Elsenfeld / Main Heribert Ley 912: 796 665 48, Kanto: 676 28
Teiefon +49 6022 / 26573 - 0 info@sunovation.de IBAN: DE71 7966 6548 0000 0676 28
Telefax +49 6022 / 26573 - 44 HRB 12571 Aschaffenburg BIC: GENO DEF 1 OBE
www.sunovation.de MAD: DE 291 423 523

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: E Duplicate or 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
Pacie 2 of this form.
(1) being first sworn, upon oath deposes and says:
Name/Claimant
On or about See a ttac_ment 1, (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 issued to him/her in the sum of $ See attachment -(3)
Signed: (4)
e: Please attach a coidly_of)the warrant/check if available and/or any other
vidence that a warrant/check was originally issued.
(5) Subscribed and sworn to before me this 'CI \ day of iAtic S 20 6
''''''' Z,".I • le AMY A. STUBBE
My commission expires: A r.; My Notary ID # 130710462
j ‘} v-Ne 2L Lo '441 Expires June 22, 2020 (seal)
r l'farraritl-Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
CI Payroll
El For Services or Goods furnished
ID Treasurer's refund/payment
Other:
TRS HOME FURNISHINGS VIC ID 11691

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360001077 7/13/2015 TRS HOME FURNISHINGS $25.00
00360003163 8/5/2015 TRS HOME FURNISHINGS $25.00
00360006094 9/8/2015 TRS HOME FURNISHINGS $25,00
00360008680 10/8/2015 TRS HOME FURNISHINGS $25.00
00360011212 11/10/2015 TRS HOME FURNISHINGS $5,00
Total $105.00

Application for a Duplicate or Stale-Dated Wabcr-alltiCheck
Iti r TO j rr
ii
Affidavit/Claim Form
This application is for: 0 Duplicate or El Staleicated (definitions kr) on page 2)
STATE OF ARIZONA Note: Numbers on this forTh-torrespond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
pane 2 of this form,
13P-Eur DElz.EK WIL-Aver, (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 issued to him/her in the 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) Subscribed and sw rp to before me this
NOTARY PUBLIC
Hall GARDNER
My commission expires: Wotan/ Pailt - State of Arizona
2A, 20 /2- PAy Commission PAARiCOPP Sig 'OUNTY Jur* mows
Warrant/Check Number
(if known) (6)
Original Date of Issue
(if known) (7)
Reason for original issue of Warrant/Check (8):
D Payroll
For Services or Goods furnished ‘,AultruAce... 3ZVE...1M. kAi ATT\icAttorl
D Treasurer's refund/payment
D Other:
WILCOCK ASSOCIATES VIC ID 22587

STATE OF ARIZONA
CORPORATION COMMISSION
E- FILED 06005953
CORPORATION ANNUAL REPORT
& CERTIFICATE OF DISCLOSURE
DUE ON OR BEFORE 6/23/2017 FILING FEE 45.00
PLEASE READ ALL INSTRUCTIONS, The following information is required by A.R.S. §§10-1622 & 10-11622 for all corporations
organized pursuant to Arizona Revised Statutes, Title 10. The Commission's authority to prescribe this form is A.R.S. §§ 10-121(A)
& 10-3121(A). YOUR REPORT MUST BE SUBMITTED ON THIS ORIGINAL FORM. Make changes or corrections where necessary.
Information for the report should reflect the current status of the corporation.
12113570
1. WILCOCK & ASSOCIATES, INC.
4100 S. LINDSAY RD STE 105
GILBERT, ARIZONA 85297
Business Phone: (Business phone is optional.)
State of Domicile: AZ Type of Corporation: BUSiNESS
2. Statutory Agent: B DEREK WILCOCK Statutory Agent's Street or Physical Address:
Mailing Address. PO BOX 50580 Physical Address: 4100 S LINDSAY RD STE 105
City, State, Zip: MESA, ARIZONA 85208-0007 City, Slate, Zip: GILBERT ARIZONA, 85297
ACC USE ONLY
if appointing a new statutory agent, the new agent MUST consent to that
Fee: 45.00 appointment by signing below. Note that the agent address must be in Arizona.
Penally: 9.00 I, (individual) or We, {corporation or limited liability company) having been designated the new Statutory Agent, do
hereby consent to this appointment until my removal or resignation pursuant to law.
Reinstate:
Expedite:
Resubmit: Signature of new Statutory Agent
Printed Name of now Statutory Agent
3. Secondary Address:
(Foreign Corporations are REQUIRED
to complete this section).
4. Character of Business:
INSURANCE
Received: 7/13/20174:11:25 PM
AR :5045 Arizona CoIporation Commission
Rev. 8 ,2016 Corporarloos Division

Arizona Corporation Commission - RECEIVED: 7/1112018 18071116267075
Ariwna Corporation Commission - FILED: 7/11/2018
2018 ANNUAL REPORT
ENTITY INFORMATION
ENTITY NAME: WILCOCK & ASSOCIATES, INC,
ENTITY ID: 12113570
ENTITY TYPE: Domestic For-Profit (Business) Corporation
CHARACTER OF BUSINESS: INSURANCE
AUTHORIZED SHARES: Share Class: common Share Series: Share Total: 1000.00
ISSUED SHARES:
STATUTORY AGENT INFORMATION
STATUTORY AGENT NAME: B DEREK WILCOCK
PHYSICAL ADDRESS: 4100 S Lindsay Rd Suite 105, GILBERT, AZ 85297
MAILING ADDRESS: PO BOX 50580, MESA, AZ 85208
KNOWN PLACE OF BUSINESS
4100 S. LINDSAY RD STE 105, GILBERT, AZ 85297
PRINCIPAL OFFICE ADDRESS
PRINCIPAL INFORMATION
Director: BRENT DEREK WILCOCK - PO BOX 50580, MESA, AZ 85208 - - Date of Taking Office: 06/21/2005
President: B DEREK WILCOCK - PO BOX 50580, MESA, AZ 85208 - Date of Taking Office: 06/21/2005
Secretary: HOLLI GARDNER -210 S JESSE STREET, CHANDLER, AZ 85225-- Date of Taking Office:
06/19/2015
Shareholder; BRENT DEREK WILCOCK - NOT REQUIRED, NOT REQUIRED, XXXXX - - Date of Taking Office;
12/31/9999
Vice-President: SHAWNAH L WILCOCK - 10461 E DOLPHIN AVE, MESA, AZ 85208 - - Date of Taking Office:
08/28/2009
SIGNATURE
President: B Derek Wilcock - 07/11/2018

Summary of Unclaimed Funds
Warrant # Issue Date Vendor Name Warrant Amount
00360003168 8/5/2015 WILCOCK ASSOCIATES $296,00
00360006104 9/8/2015 WILCOCK ASSOCIATES $276.97
Total $572.97