011718 DUPLICATE WARRANTS 11.PDF

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency (aka RECEIVE
Maricopa County Superintendent of Schools Office)
DEC 1 4 2017
IVIARICOPP , COUNTY'
CLERK BOARD OF FJUPERVISORS
TO: CLERK OF THE BOARD V.69
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 12/12/2017
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.
#08 Osborn Jill Adams — All Paths Yoga LL #470096018 $180.00

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AFFIDAVIT
RK, BOARD OF SUPERVISORS
MARICOPA COUNTY
STA'lk, OF ARIZONA
COUNTY OF MARICOPA
ji J aciams41( I Rtfils, bIng first duly sworn, upon oath deposes and says: -
That on the el da of ML 20 (3, he presented to Dth6n1 ,...hod ( agfild-
District of Marlcopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of i1104 2011, said claim being in the sum of
DI/ICIV.InahiLl kit4: Dollars, (it) ' ----rin payment of which the
Superintendent of Schools caused his/her Warrant Number IN befi(rotg to be
issued on 1110AA_P, 20 n, drawn on the Fund of nsbntol
District of Maricopa County, Arizona.
Affiant further says that although he/she was Informed and believes that the above
mentioned warrant was regularly Issued, the same has never been received, or has
been lost.
WHEREFORE, affiant prays that the Board of Supervisors order and the
Superintendent of Schools issue to him/h 1 a duplicate of said Warrant Number
in the sum of $ IEb
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Signed: aa,b. Z 2_ ,- N
CO cgocr aND N d V) g
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Subscribed and sworn to before me this 6 day of*401/26" ,20 / 1, ozooriv
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( NOTARY PUBLIC I < 1-120 Eo
My commission expires: o 1 • - ,i,7-,,,It.4 .. Z o .
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Following approval pleaso return this affidavit to the Maricopa Count y School Superfntengents Office.
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