Extracted text (via pymupdf_layout)
4294 characters
RECEIVED INTEROFFICE MEMORANDUM MAR ICOPA COUNTY CLERK BOAND Ut- bUHERVISORS Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) '01 TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 5/17/2018 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. #25 Liberty Elementary Alyssa Jasinski $718.71 #45 Fowler Elementary Eugenia Sauriol $1,125.66 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. 4lysca -Tag in Sled (1), being first sworn, upon oath deposes and says: N6me/Claimant On or about 14/A 4/24/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/4r in the sum of $ 7/2. .(3) Signed: (4) (5) Subscribed and sworn to before me this 4 day of Mal, 20 IV. NOTARY PUBLIC DEyy LJACkSON My co mission expires: NOTARy Public - STATE Of ARIZONA I MARICOPA COUNTY (seal) My Comm, EXPES low 3, 2022 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 (if known) (6) 3 7666 222.5-7 (eic- 4 ,256.0 30 6 1/ ) Original Date of Issue (if known) (7) 171/-1Cotao/2 A gem Ir- - Reason for original issue of Warrant/Check (8): 3Nt Payroll El For Services or Goods furnished CI 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. SAURIOL, EUGENIA (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 05-04-2018 (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 $ 1125.66 .( 3) Signed: ON' (4) (5),.8ancribed and to before me this /14k day NOTARY PUBLIC OFFICIAL SEAL Mv commission expires: Notary BARBARA Public M. - Arizona GILL i +t,26 9 MARICOPA COUNTY (seal) My Commission Expires 201g 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 45235663 (if known) (6) Original Date of Issue 5-04-2018 (if known) (7) Reason for original issue,of Warrant/Check (8): Payroll El For Services or Goods furnished El Other: MARICOPA COUNT), 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