011117 DUPLICATE WARRANTS 2_REDACTED.PDF

INTEROFFICE MEMORANDUM
Waricopa County Schoo( Superintendent's Office
TO: CLERK, OF 'PA WAR (1)
FROM: (fie 'Thompson
SUBJECT: Affidavits
DATE: 12/8/2016
Prease find attached 2 AffidavitOotice of Craim(s)for Cost warrants for indusion on
the ne_Kt avaiCa6ie Ooard agenda
.•1 The attached item(s) have 6een researched to ensure that the warrant(s) in
question have not 6een cashed or previously re-issued
Die warrant(s) have liad a stop payment done.
If you have any questions, Oase contact Millie Thompson at 372-1244 or via e-mait - at
mthompson@mcesa.man'copa.gov. Approved Affidavits may 6e routed 6ack to the
Superintendent of School - finance Division at 4041 N. Central Avenue #1200, ( 12 th
Efoor) Thankyou.
#47 ARLINGTON AXGELIQUE TEDERICO $325.46
#66 ROOSEVELT NICOLE ROW() $647.91
RECEIVED
DEC 0 8 2015
CLEf; LO.it D OF'S r:OUNTY UPERVIS
N ORS

(0'
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.
Nicole Romo (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about / /A3416 / 0 (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 $ 647.91 .(3)
Signed: (4)
(5) Subscribed and sworn to before me this day of p/3/ Ako - 20.,01.6
7-
-)r /
NOTARY PUBLIC
Notary Public State of Arizona
My commission expires: Ana Ma ricopa A Moran County
My Commission Expires 07/0312017 (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 170033123 A 1-4' le " %1 v A4 A"
(if known) (6) JA Eci - C 9 1016
Original Date of Issue 11/23/2016
(if known) (7) . • ,
Reason for original issue of Warrant/Check (8): MARIC 0 .A,
• Payroll
0 For Services or Goods furnished EE never received check in mail
II Other: EE never received check in mail
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

Affidavit
Okik- #1.0
STATE OF ARIZONA APPROVE
CO9 2016
COUNTY OF MARICOPA )
v. a• K, = OARD - 0 SUPERVISORS
MARIGOPA COUNTY
4 Ilqd ate e being first duly sworn, upon oath deposes and sa ys:
That on the N day of A1L2I/e4thef , 20 he presented to the
AA Y/OildWitZ)/ &0577 of Maricopa County, for payment, a claim for services
rendered or supplies furnished durin g the month of A/OVeab-er . (i , said claim bein g
in the sum of he_frddifh, , ' Dollars ($ 375 )
, z,_.„ — i LI , 2.:— er
in payment of which the Superintendent of Schools caused his/her Warrant No. /---1/b 7i1W.f..) 7
to be issued on AM Veintbe- e,eZ , 20 , drawn on the5,71 Fund of
rld/n9/7W152/110/ of Maricopa County, Arizona.
Affiant further says that although he was informed and believes that the above mentioned
warrant was regularly issued, the same has never been received or has been lost.
WHEREFORE, affiant prays that the Board of Supervisors order and the Superintendent of
Schools issue to him a duplicate of said warrant number '4/75-1/dZ61 in the sum of
$
Subscribed and sworn before me this day of /.•e-e-einifi 20 /
/
OFFICIAL SEAL
MELANIE FINCHUM
NOTARY PUBLIC - ARIZONA
VIARICOPA COUNTY 4-/-/
My Comm Expires 04 01 2019
My Commission Expires
Following approval please return this affidavit to the Maricopa County School Superintendent's Office.
FI:\Work\Affidavit.doc 07/14/05

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency (aka
Maricopa County Superintendent of Schools Office)
TO: CLERK OF THE BOARD
FROM: Denise Weihe
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 12/8/2016
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 Denise Weihe at 602-372-1245 or via e-mail at
denise.weihe@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.
#214 Tolleson Union Minna Cavanaugh/NASSP $163.75
VET)
DEC 08 2016'
CLERK MAP;ICOrri BOARO COUNTY
SUPL--RVISORS

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.
1 1 6), being first sworn, upon oath deposes and says:
NameiGiaimant /\:145
On or about March 31, 2016 (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 $ 163 .75 43)
Signed: (4)
(5) Subscribed and sworn to before me this / day of ,691140,0,- 20k_.
NOTARY PUBLIC
....... L
My commi sion apj i7 : . Q/NOTARY
cdim ry 11 E)11, ax z PUBLIC(seaV\z_ s
cc') • REG It 254513 • •
MY uu ittg**4=.
co) EXPIRES
Note: Please attach a copy of the warrant/check if available*d(0 43 ...... 91?..ifk
evidence that a warrant/check was originally issued. LTV\ (): .
Warrant/Check Number 460087630/214728444
(if known) (6)
Original Date of Issue 8/31/16
(if known) (7) DEC 9 20t,
Reason for original issue of Warrant/Check (8): BOARD OF SUPERVISO
El Payroll MARICOPA COUNTY
El For Services or Goods furnished
Other: Tolleson Union High School purchase order 1604775.
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

NASSF1
^11 National Association
of Secondary School Principals
November 29, 2016
Dear Sir or Madam:
This is to certify that I, Minna Cavanaugh, am authorized to sign off on various financial
affidavits.
Minna Cavanaugh
Accounts Receivable Manager
1904 Association Drive, Reston, VA 20191-1537
P 703.860.0200 F 703.860.3422
www.nassp.org