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INTEROFFICE MEMORANDUM RECEIVED Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) MAY 1 7 2018 MARICOPA COUNTY CLERK BOARD OF SUPERVISOR!: TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 5/17/2018 (#2) 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 AZ School Counselors Association $1,500.00 Note* I spoke with Cein Luke today, who stated the attached Vendor Letter is the best that she could generate because Arizona School Counselors Association is solely ran on volunteers throughout the state of AZ. The "Business Office" is a de-centralized office of one.... her. 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. AZ School Counselors Assn (1), being first sworn, upon oath deposes and says: Name/Claimant On or about II PO ao (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 $ 1500.00 .(3) Signed: (4) ubscribed andorn to before me this ( "3 day of --r9e5--- 20 . NOTARY PUBLIC Ray Rijo MyRrinmissi n expi s: Notary Public Maricopa County, Arizona (seal) My Comm. Expires 07-31-19 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 480061765 A 4'' F 1 ..i II'.101 (if known) (6) • Original Date of Issue 01/16/20'18 DA • • / (if known) (7) CLERK, MARICOPA BOARD OF COUNTY SUPERVISORS Reason for original issue of Warrant/Check (8): 0 Payroll 171 For Services or Goods furnished &r-l-rouf-PDY"- 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