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INTEROFFICE MEMORANDUM Maricopa County Education Service Agency (aka Maricopa County Superintendent of Schools Office) RECEIVED NOV 22 2017 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS TO: CLERK OF THE BOARD (ctri s70 FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 11/21/2017 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.ysaguirre@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. #31 Balsz Elem Mark Paulsen #480012393 $10.47 #31 Balsz Elem Mark Paulsen #480014757 $11.22 AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA CLERK, BOARD OF SUPERVISORS MARICOPA COUNTY N r:)/c14. --P PrtA L.S€JJ , being first duly sworn, upon oath deposes and says: (Name and Title of Person) That on 3 U.L.Lj , 20 / "7, he/she presented to -?:•FIG.52. ‘..9040.01..... 6 I-.ST . tit .3 I of (School District Name) Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of L.4 h-A-1 , 20 J 7, saidclaimbeinginthesumof ($ / 0 orIcQ 40/ toO Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number sig 6 r) IAS gs to be issued on 2 Acie4-L4 s T., 20 I -7, drawn on the 001 Fund of 214436 *21 of (School District Name) 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/her a duplicate of said Warrant Number 5t?CO /AT ' 3 in the sum of $ / 0 . . Signed: (Name if d Title of Authorized Personnel) Subscribed and sw rn to before me this \ ...ah... ( k•\"-- day of \\\.1z.,,%.,,,_\c,..,_,— , 20 .....\__ _-- ARACELY SOTO NOTARY PUBLIC: NOTARY PUBLIC - ARIZONA MARICOPA COUNTY My Commission Expires My commission expires: March 29,2019 Following approval please return this affidavit to the Maricopa County Education Service Agency Office. AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA poe PPS- Li , being first duly sworn, upon oath deposes and says: (Name and Title of Person) That on 40 44 11- 11ST, 20 /7, he/she presented to 113n1-4S Z cSCI-tc)01....bk31'. 41'31 of (School District Name) Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of 41.4..c.itt.s r , 20 /1 , said claim being in the sum of ($ /1. AN ) E4N-E-L..) °tin c.fi, / c, Dollars in payment of which the Superintendent of Schools caused his/her Warrant Number gn o 4 111 to be issued on /5- hucit ,20 / , drawn on the CO/ Fund of 2)1s-r.1r3( of (School District Name) 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/her a duplicate of said Warrant Number 41g00/ 1415/ in the sum of $ / . izsA Signed: (Name and Tiffe of Authorized Personnel) Subscribed and sworn to before me this \C:=.3`-\-s" day of , 20 V \- ARACELY 80 -10 — NOTARY PUBLIC: L NO TARY PUBLIC - ARIZONA MARICOPA COUNTY My Commission Expires My commission expires: March 29, 2019 Following approval please return this affidavit to the Maricopa County Education Service Agency Office.