Extracted text (via pymupdf_layout)
5348 characters
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: 10/30/2017 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 terrLysaguirre@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. #214 Tolleson Union Norma Cuevas De Sabillon #180021037 $591.35 #05 Isaac Elem Treasures 4 Teachers #480008946 $3,750.00 RECEIVED OCT 3 1 2017 MARICOPA cougr.•,' CLERK BOARD OF SUPERVISORS 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. Norma Cuevas De Sabillon (1), being first sworn, upon oath deposes and says: Name/Claimant On or about October 13, 2017 (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 $ 591 . 35 .(3) Signed: ,U1L; (4) (5) Sypscribed and sworp to before me this 21. 40 day of Oc-frAge K- 20 /1- . LYNETTE STARK My commission expires: Notary Pone- stste amnia My Commission MARICOPA Expires COUNTY Juno 15, 2018 (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 214742603/180021037 (if known) (6) Original Date of Issue 10/13/17 (if known) (7) Reason for original issue of Warrant/Check (8): IU Payroll LI For Services or Goods furnished HUARD CF SLIFF I , VICC't-S D Other: vgRhMPA 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 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 Iceti FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 11/20/2017 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda 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. #05 Isaac Elem Treasures 4 Teachers #480008946 $3,750.00 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. —1---CeaSLer-cx ie_rid-v2r3 (1), being first sworn, upon oath deposes and says: Name/CTaimant - On or about 7 / 1 (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 $ .(3) Signed: 5isaclev> (4) (5) Subs,cri.bed and sworn to before me this )0 day of NO Vetliber 20 / NOTARY PUBLI My commission expires: CHERYL ANN MANGOTICH og.D-0/6 Notary Public Arizona (Seal) Maricops County • • 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) Z— — 66.— (// -)69-1L0 Original Date of Issue —1 /.a i (if known) (7) 1 Reason for original issue of Warrant/Check (8): 1E1 Payroll APPRO E )gr For Services or Goods furnished DAT I/ to,v LI Other: erL - TM - AK BOAR r Curcn VIC, OR S MARICOPA COUNTY SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claincloc Revised June 2015 A.R.S. 11-632 & 15-999