102517 DUPLICATE WARRANTS 1.PDF

RECEIVED
SEP 2 0 2017
INTEROFFICE MEMORANDUM MARICOFA COUNTY
CLERK BOARD OF SUPERVISORS
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: 9/18/2017
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.ysaguirrePmcesa.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 DECA Images #470109626 $356.00

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.
DECA Images (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about (Q/ DI AD/ ,date, )(2) a warrant/check was issued to the
above named perso /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 $ 356.00 .(3)
Signed: tr)c. IAA t (4)
(5) Subscribed and sworn to before me this day of - -ryl-C4tb4)), 20 /
-44„‘t:4 _ tk osteue,,,,to
o\INBE
NOTARY PUBLIC ***. <e\ .
•°0
My cymmission expires: MY
dr.g/az 4- • COMMISSION NumE0eal); •
A•s: 0 "" • 315014 • •
Note: Please attach a copy of the warrant/check if available anrirotw iteix„other
evidence that a warrant/check was originally issued
Warrant/Check Number 470109626 --, T,7 r 17)
(if known) (6)
Original Date of Issue SET• 2 7 2017 ,
06/20/2017
Reason for original issue of Warrant/Check (8): -K, BOARD OF SUPERVISORS
0 Payroll MARICOPA COUNTY
For Services or Goods furnished classroom materials
El Other: classroom materials
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 8r. 15-999

RECEIVED
SEP 25 2017
INTEROFFICE MEMORANDUM MARIC;OPA COUNTY
CLERK BOARD OF SUPERVISORS
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: 9/21/2017
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 terriNsaguirre@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.
#216 Agua Fria Swagge Marching Arts #470088363 $530.00

h(k
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 pa ge 2 of this form.
SWAGGE MARCHING ARTS (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 4/11/2017 (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 $ 530.00 .(3)
Signed: (4)
(5) Subscribed and sworn to before me this e day of .) 20 / .
NOTARY PUBLIC
NOTARIAL SEAL
Thomas V. Amoroso, Notary Public
My commission expires: Stroudsburg Borough, Monroe County
4/11/2017 --V-2-a) My Comm. Expires December 11, 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 47008363/216707380
(if known) (6)
Original Date of Issue 4/11/2017
(if known) (7)
Reason for original issue of Warrant/Check (8):
CI Payroll
141 For Services or Goods furnished DIGITAL FLAGS 36 X 54
El Other: DIGITAL FLAGS 36 X 54
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

RECEIVED
E=13-62=017
INTEROFFICE MEMORANDUM
MARICOPA COUNTY
CEEFKBUTI=YrSTJPERVISORS
Maricopa County Education Service Agency (aka
Maricopa County Superintendent of Schools Office) irkteeofficv
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 9/22/2017
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.
#216 Agua Fria Nicholas Roberts #470110110 $410.00
#509 MCRSD Riester Sonoran, LLC #480014066 $500.00

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.
NICHOLAS ROBERTS (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 06/20/17 (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 issu the sum of $ 410.00 . (3)
Signed: (4)
(5) Subscribed and sworn to before me this day of ' ep-k--cprIbc-r 20 n
(211\A_CA Ds alik.
NOTARY PUBLIC
DANA GIEBELMAN
NOTARY PUBLIC, ARIZONA
My commission expires: MARICOPA COUNTY
06/20/17 Hp. I V" -j= V My Commission April 15, 2019 Expires (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 216709409/470110110 A
(if known) (6)
Original Date of Issue 2/6/17 DAT' 7 zuy
(if known) (7)
MtL-1- Ler7PV
Reason for original issue of Warrant/Check (8): k, MARICOPA BOARD OF COUNTY SUPERVISORS
0 Payroll
I* For Services or Goods furnished SECURITY FOR VHS/AFHS GRADUATION
LI Other: SECURITY FOR VHS/AFHS GRADUATION
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.
Riester Sonoran LLC (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about August 11, 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, gr 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 i d to him/her in the sum of $ 500.00 -(3)
Signed: (4)
(5) Subscribed and sworn to before me this I 5-11- day o 20 1 .
TAW-PUBLIC
JODI TUCKER
Notary Public,State of Arizona
My commission expires: Maricopa County
May oz My May Commission 02, 2020 Expires (seal)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warranVcheck was originally issued.
Warrant/Check Number 480014066
(if known) (6)
Original Date of Issue August 11, 2017
(if known) (7)
Reason for original issue of Warrant/Check (8):
El Payroll
*I For Services or Goods furnished
111 Other:
S: \PROCESSES \Warrants - Duplicate or Stale \02 Forms\Schools\Schools-Warrants Checks notice of daim.doc
Revised June 2015 A.R.S. 11-632 & 15-999