072617 DUPLICATE WARRANTS 6.PDF

MCESA
Maricopa County Education Service Agency
INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency
TO: Clerk of the Board
FROM: CARRIE GUNDERSON
SUBJECT: Affidavits — Replacement of Lost /Stale Warrants
DATE: 6/28/2017
PLEASE FIND ATTACHED AFFIDAVIT/NOTICE OF CLAIM(S) FOR LOST WARRANTS FOR
INCLUSION ON THE NEXT AVAILABLE BOARD AGENDA.
\I The attached item(s) have been 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, please contact Carrie Gunderson at (602) 372-4833 opt.3 or via e-
mail at garnishments(@,mcesa.maricopa.gov . Approved Affidavits may be routed back to the
Maricopa County Education Service Agency at 4041 N. Central Avenue #1200, (12th Floor)
Thank you.
Fund 781
Vincent Vasquez 1 7007721 6 Dated 6/1/17 for $3077.22
RECEIVED
JUN 2 9 2017
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
:DO Cf)N ALL_
4041 N. Central Avenue, Ste. 1200, Phoenix AZ 8501 2 • Phone 602-506-3866 • Fax 602-506-
3753
www.maricopa.gov/mcesa Twitter: #mcesaaz Facebook: mcesaaz

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.
Vi f SoW-6-7- (1), being first sworn, upon oath deposes and says:
Name 7 laimant
On or about 6 - - ?(Ji (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 ssued him/her in the sum of $ 7-1-, 43)
Signe (4)
(5) Subscribed and sworn to before me this (9/14:44 day o 20/'7 .
0,11)tt,17-)C'a Chee--7X7L)
NOTARY PUBLIC
CHRISTINA L CHARETTE
Notary Public - State of Arizona
My commission expires: MARICOPA COUNTY
- My December Commission 17.2018 Eviree (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 / -0(‘) 7i-d- / 6
(if known) (6) APP‘OyED
Original Date of Issue
(if known) (7) 6 - i -
Reason for original issue of Warrant/Check (8):
,Ti. Payroll CLERK, MARICOPA BOARD OF COUNTY SUPERVISORS
El For Services or Goods furnished
111 Other:
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)
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 6/29/2017
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-, plea'Se contact TOrri Ysaguirre at 602-372-1245 or via e-mail
at theresa.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 Alexander Rond Jennings $402.62
#401 EVIT Phoenix Welding $665.37
RECEIVED
JUN 29 2 017
Mic )PA COUNTY
CLERK B -6,=,,ID OF SUPERVISORS
t

2_1(a0
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.
Alexander Jennings (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about June 1, 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 $402.62 .(3)
Signed: _ (4)
- -
(5) Subscribed and sworn to before me this /-6 -4--)) day of Lt I _ 20
'C'
NOTARY PUBLIC , i AittIAe,„„i\ OFFICIAL SEAL t
COLETTE HAYES I
My commission expires: Notary Public- State of Artzona !
-*me-41-2w- V .71, .._47 MARICOPA COUNTY I)
• ./int_?/ My Comm. Expires Oct 15, 2019`"
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 216708853 noon (0 -1 1
(if known) (6)
Original Date of Issue June 1, 2017
(if known) (7)
Reason for original issue of Warrant/Check (8):
1:$1, Payroll
LI For Services or Goods furnished
0 Other:
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
APP
le it. P A 1
DA
dr
CLERK, BOARD OF SUPERVISORS
MARICOPA COUNTY

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.
4)6Tarnant ("3 fe (1), being first sworn, upon oath deposes and says:
On or about 1 21/57 / (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 owin and the applicant requests that a replacement
warra nt/ch.c-k-bej,ssug,ey o7110/ber $ 17-4S 3 —7 .(3)
Signed: (4)
(5) Subscribed and sworn to before me this AO day of JAW) 20(7 .
NOTARY PUBLIC MAIRE HYDE
NotaryPublic-Stateof Arizona
My commit sioj expires: My MARICOPA Commission COUNTY Expires
11 November 8, 2020 (seal)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
v•L
Warrant/Check Number H -7006Apich , Jai
(if known) (6) D i'm
Original Date of Issue IS 201 - Q2 . ' „_•.: • Pfir .- •
(if known) (7) I 2 - — 6,,m,it-lac.
Reason for original issue of Warrant/Check (8):
LI Payroll
1114or Services or Goods furnished—A-S-62-0-3-3-3 2h3iLL
El Other:
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