Extracted text (via pymupdf_layout)
2424 characters
MARICOPA COUNTY soAlio OFS Department of Finance NARICOPA r•I')1•, 301 West Jefferson, Ste 969 Is pi; f ,?, Phoenix, Arizona 85003 Pic"a INTEROFFICE MEMORANDUM Date: July 18, 2017 To: Clerk of the Board From: Kathy Baskom Department of Finance Subject: Affidavits — Replacement of Lost Warrants Please find attached 1 Affidavits for lost warrants to be included on the next available Board Agenda. • The attached items have been researched to ensure the warrant in question have not been cashed or previously re-issued. • The original warrants have a void/stale date/stop payment done. Please call me at 506-0572 if you have any questions. Please return the approved Affidavits to , ny attention in the Department of Finance, Suite 960. Thank you. Re: Estela Garcia Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: Duplicate or 0 Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is baqe 2 of this form. Estela Garcia (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 13-Jun-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 $ 10,000.00 .(3) Signed: 06&274/ 6,LL} (4) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. 5. Subs and sworn to before me this 1;: day of - YU 20 YVETTE C. SANCHEZ commission expires: Notary My Commission Public, State Expires of Texas vi St. I CI I 2_01 , , ;;;,,s• August 19, 2018 (seal) Warrant/Check Number 370026360 (if known) (6) Original Date of Issue 13-Jun-2017 (if known) (7) Reason for original issue of Warrant/Check (8): dr tRK BOARD OF SuPERVISORS MARICOPA CC _,NiTY 0 Payroll For Services or Goods furnished 0 Treasurer's refund/payment El Other: Settlement GL5075124164385