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INTEROFFICE MEMORANDUM Ifaricopa County School-Superintendent's Offic TO: CLERX0E TOE OAR (1) FROM: Witrie Thompson SUBJECT: Affidavits DATE: 3/9/2017 Pase _find attached 2 Affidavit/N -otice of Claim(s)for Cost -warrants for incrusion on the next avaiCa fife cBoarclagencfa 4 The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previousfy re-issued The original- warrant(s)have had a stop payment done. If you have any questions, pfrase contact Millie 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 X Central-Avenue #1200, ( 12 tfi Efoor) Thankyou. #59 LAVEEN SETENTEXPRISES $34.04 #65 LIV_ILETON KRISTI.9\A ,STSS LER $392.29 RECEIVED MAR 09 2017 MARICOPA COUNI Y CLERK BOARD OF SUPERViSORS A (J) Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: 0 Duplicate or 0 Stale-Dated (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 1 \ (1), being first sworn, upon oath deposes and says: Name Claimant On or about la \t,, s\ (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 $ c:)-q 43) Signed: (4) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. scribed and swo me this day of 20 17. II NOTARY PUBLIC Anamarla QuIntanItla My commission expires: Marlcopa Notary County, Public Arizona fYin-= ,\ ) 5, ?-c' My Comm. Expires 06-15-18 (seal) Warrant/Check Number (if known) (6) Igoo4a -14rD Original Date of Issue (if known) (7) la\aKk-zoRe ReasopAr original issue of Warrant/Check (8): L,L ( V Payroll DATA 0 For Services or Goods furnished 0 Treasurer's refund/payment CLERK 0 Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644 -461 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: gl Duplicate or 0 Stale-Dated (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. SET Enterprises Inc. (1), being first sworn, upon oath deposes and says: Name/Claimant On or about January 19, 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 isance. 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 issuedild. to irn/her 1 in the sum of $ Thrity-four and 04/100 .(3) Signed: ovo (4) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. ( u s ,,sed and sworn to before me this 6961 day of fth r)-0 20 / 7 . /9////, c ...em NOTARY PUBLIC 4+4111111e4 -VatbIr BRENDA SCHAR NOW NOTARY PUBLIC - ARIZONA My-,corpmission expire Z17 ".111111111.1 .) Maricopa County U07` A My october Commission 12, 2018 Expires (seal) Warrant/Check Number 470062810 (if known) (6) Original Date of Issue January 19, 2017 (if known) (7) Reason for original issue of Warrant/Check (8): Payroll I For Services or Goods furnished El Treasurer's refund/payment El Other: S:\PROCESSES\Warrants - Duplicate or Stale \ 02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644