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INTEROFFICE MEMORANDUM llaricopa County Schoo( Superintendent's Office TO: CLERX TOE 0 .04q0) RECEIVED FROM: 911iffie 'Thompson JUL 2 4 2017 SUBJECT: _Affidavits IVIARICOPA COUNTY DATE: 7/21/2017 CLERK BOARD OF SUPERVISORS Please _find attached 3 Affidavit/Arotice of Claim(s)for lost warrants for inclusion on the ne)ct available oard agenda The attached item(s) have 6een researched to ensure that the warrant(s) in question have not been cashed or previously re-issued The original warrant(s)have had a stop payment done. If you have any questions, 'Pthethe contaCt Marie Thompson at 372-1244 or via e-mail at mthompson@mcesa.maricopa.gov . Approved _Affidavits may be routed back to the Superintendent of School" finance (Division at 4041 N. Central Avenue #1200, ( 12 th 'Floor) Thankyou. #60 .1fIGLET SILVENA NTJCATCYCER $398.19 #68 A L. irAWMA GVITARCENTLRSTORS $1067.07 #216 AGVA ERIA DANA glICCARTY $1533.09 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. SILVENA N THATCHER (1), being first sworn, upon oath deposes and says: Name/Claimant On or about (clate)(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/ct, cl ‘ be issued to hi /her in the sum of $ 398 . 19 .(3) Signed: (4) (5) Subscribed and sworn to before me this day of 71- )1 20 11 NOTARY PUBLIC PUBLIC OFFICIAL—SEAL-- LEAH CRUZ Notary Public - State of Arizona My commission expires: MARICOPA COUNTY I [0 - )(, 1 61 My Comm Expires Oct 28, 2019 (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 60519476 ' igoo00/5- 1 (if known) (6) j Original Date of Issue 07/06/2017 (if known) (7) Reason for original issue of Warrant/Check (8): *I Payroll II For Services or Goods furnished CLERK, BOARD OF SUPE VISORS LI Other: MARICOPA COUNTY 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. Guitar Center Stores (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 03/23/2017 (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 $ 1067.07 .(3) Signed: (4) (5) Subscribed and sworn to before me this // /1-1` day of JO 4( 20/7. Commission # 2079660 Notary Public - California Riverside County Comm. Expire Aug 28, 201 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 470082226 if known) (6 Original Date of Issue 03/23/2017 If known) (7 Reason for original issue of Warrant/Check (8): D Payroll LtRK BOARD MAIRICOPA OF SUPERVISORS COUNTY D For Services or Goods furnished ki Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Fornis‘Schools\Schools-Warrants Checks notice of clalm.doc A.R.S. 11-632& 15-999 Revised June 2015 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. Dana Mccarty (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 7- Z0 -I 7 (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 $ 1533 . 09 .(3) Signed( (),(1i1} c114 ,np Ci, L_ALAjj (4) (5) Subscribed and sworn to before 4his 2-0 day of 201:1. NOTARY PUBLIC OFFICIAL SEAL ' ti Notary BIANCA Pubic- PERDOMO State of Arizona ; My commission expires: i MARICOPA COUNTY ! My Comm. Expires April 27, 2021 i (seal) Note: Please attach a' . copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. i Warrant/Check Number 180002340 (if known) (6) Original Date of Issue 7/13/2017 I (if known) (7) I .. 'OW we, Ira A W V WS 71 Reason for original issue of Warrant/Check (8): DAT Payroll El For Services or Goods furnished K MARICOPA BOARD OF COUNTY SUPERVISORS LI Other: S:\PROCESSES\Warrarits - Duplicate or Stale \02 Forms \Schools \Schools-Warrants Checks notice of claim.doc A.R.S. 11-632 & 15-999 Revised June 2015