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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 7/20/2018 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.vsaguirre@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. #60 Higley Unified Alyssa D Strohmaier $1,119.75 #60 Higley Unified (lof3) Adriana Lee Cardani $1,083.65 #60 Higley Unified (2of3) Adriana Lee Cardani $1,083.65 #60 Higley Unified (3of3) Adriana Lee Cardani $1,083.72 #60 Higley Unified (1of3) Maryn Elizabeth Cole $1,161.88 #60 Higley Unified (2of3) Maryn Elizabeth Cole $1,161.82 #60 Higley Unified (3of3) Maryn Elizabeth Cole $1,161.82 RECEIVED JUL 23 2018 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS 11C) aPc 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. ALYSSA D. STROHMAIER (1), being first sworn, upon oath deposes and says: Name/Claimant On or about (..0, /0 7 F (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/h in the sum of $ 1119.75 .(3) e- Signed: (4) cribed and sworn to before me this day of 20 X-42±1-1 PUBLIC OFFICIAL SEAL LYNETTE STEWART j My nni7n expires: Notary Public-State of Arizona / 7 MARICOPA COUNTY (seal) gy My Comm. Expires Sept, 17, 2020 wee If M.11111 Mil I I 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 60558959 / 3 70004N 3 ci 7 (if known) (6) Original Date of Issue 06/07/2018 I (if known) (7) i APPlituVED Reason for original issue of Warrant/Check (8): Payroll D For Services or Goods furnished CLERK, MARICOPA BOARD OF COUNTY SUPERVISORS LI 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. ADRIANA LEE CARDANI (1), being first sworn, upon oath deposes and says: Name/Claimant 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/c eck be issued to him/her in the sum of $ 1083.65 .(3 ) Signed: (4141' (4) (5) Subscribed and sworn to before me this day of -7,J (i 20 . A NOTARY PUBLIC —.......—.......••-----.......................„ OFFICIAL SEAL I ., 0 OS 470# LEAH CRUZ i My commission expires: t Not Public - State at Arizona I '. MARICOPACOUKTY I Jo - )6-19 . t• My Comm. Expires Oct. 26, 2019 I (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 (if known) Number (6) 60558037 3 `"") DOO coODI Original Date of Issue 06/07/2018 (if known) (7) I_APPRnsrlor. I Reason for original issue of Warrant/Check (8): DAT Payroll triAtqr i El For Services or Goods furnished CLERK, MARICOPA BOARD OF COUNTY SUP R. SOR OataLed LI 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. ADRIANA LEE CARDANI (1), being first sworn, upon oath deposes and says: Name/Claimant On or about L- U 7- (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/chgck be issued to him/her in the sum of $ 1083.65 .(3) Signed: (4) (5) Subscribed and sworn to before me this lc( day of 20 ir. NOTARY PUBLIC OFFICIAL SEAL LEAH CRUZ p. Notary Public - State of Arizona My commission expires: MARICOPA IVIMINILAJrn lay COUNTY l• I • - I /o- 9 6- (9 • OW My Comm. Expires Oct. 26, 2019 !, (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 60558589 7 3 --i Do 0 q35--g) (if known) (6) Original Date of Issue 06/07/2018 (if known) (7) kinisilimetwirr Reason for original issue of Warrant/Check (8): Payroll LI For Services or Goods furnished CLERK, VA BOARD -2 1: OF COLP,,Tv SUrrE7MO 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. ADRIANA LEE CARDANI (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 67 - (S' (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 $ 1083.72 .(3 ) Signed: 40(y/fetoex., (4) (5) Subscribed and sworn to before me this m day of T.., 20 IF . NOTARY PUBLIC • zoo I li li OFFICIAL SEAL ! LEAH CRUZ i My commission expires: - .. z Notary Public - State of Arizona ; /G-• )(9-0 . .4 i; MARICOPA My Comm. Expires COUNTY Oct. 26, 2019 1 ! (seal) i.......„... •...........•......•_••_•....••.....•.....•.....••.... 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 60559090 (if known) (6) h -7 00() q q q 7g Original Date of Issue 06/07/2018 --... (if known) (7) I Any' rs OilI IR . Ire Wm. Reason for original issue of Warrant/Check (8): Ari Payroll Iltfr ILf.as Li For Services or Goods furnished CLERK, MARICOnA BOARD OF COUNT'' SUE LI 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. MARYN ELIZABETH COLE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about Zo /0 7 ( (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 $ 1161.88 .(3) 6w,s, Signed: (4) (5) Subscribed and sworn to before me this day of 1—„i y 20 NOTARY PUBLIC OFFICIAL SEAL My commission expires: Notary LEAH Public - State CRUZ of Arizona /6.-)6/q- ).f / MAR . ...1C_OP.A. (CU IJTY (seal) ; My Comm. Expires Oct. 26,2019 ! 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 3700044642/60559254 (if known) (6) Original Date of Issue 06/07/2018 (if known) (7) 1 - i 7 - - Reason for original issue of Warrant/Check (8): DAT. Payroll CLERK, BOARD OF SUP.€1516OR El For Services or Goods furnished MARICOPA COUNTY ID 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. MARYN ELIZABETH COLE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about /0:2 (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 $ 1161.82 .(3) Signed: (4) (5) Subscribed and sworn to before me this 0-- day of 20 14 . NOTARY PUBLIC x t. SEAL - • 1 LEAH CRUZ 0 Notary Public -State of Arizona My commission expires: MARICOPA COUNTY /6- ; 9, MyComm. Expires Oct. 26, 2019 ! (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 3700042161/60558737 (if known) (6) Original Date of Issue 06/07/2018 (if known) (7) Reason for original issue of Warrant/Check (8): Payroll CLERK, BOARD OF SUPERVISORS 0 For Services or Goods furnished MAR1COPA COUNTY 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. MARYN ELIZABETH COLE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about LID'? II? (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 VI the sum of $ 1161.82 .( 3) Signed: (4) (5) Subscribed and sworn to before me this /.1.- day of 20 NOTARY PUBLIC OFFICIAL SEAL I.1 LEAH CRUZ i My commission expires: Notary Public - State of Arizona i I(-J9 MARICOPA COUNTY I (seal) i.. .!._1"--irit i____Sr MyComm, Expiras Oct. 28, 2019 ! 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 3700043730/60558197 (if known) (6) Original Date of Issue 06/07/2018 (if known) (7) 1 1 A IS • :d Reason for original issue of Warrant/Check (8): 11j$ ./AL Payroll 0 For Services or Goods furnished CLERK, MARCOPA BOARD OP COUNTY SUPERVISORS LI 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