Extracted text (via pymupdf_layout)
6156 characters
INTEROFFICE MEMORANDUM 911aricopa County School "Superintendent's Office TO: CLERXOT TOE WARD FROM: Willie Thompson SUBJECT: Affidavits DATE: 11/3/2016 Please find attached 3 AffidavitOotice of Cfaim(s)for Cost warrants for indusion on the nek-t avada6Th avrd agenda The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previous& re-issued The original. warrant(s) have had a stop payment done. If you have any questions, pk.ase contact 911iilie 'Thompson at 372-1244 or via e-mad at mthompson@mcesa.maricopa.gov . Approved Affidavits may be routed back to the Superintendent of School . 'Finance (Division at 4041 X. CentrafAvenue #1200, ( 12 th Eroor) Thankyou. #59 L)1VEEN JAS514INE10.701 -SON . (2) $ 82.39 $167.79 #68 ALI-rAgyom gvADALropE gv1AXIIIVEZ $1711.85 N 0 2016 r ft A COUT1 CLERK 1?0,1\fiD OF , iPERVISORS a(c ;( 0 4 1(3y) 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. 1VIC1 Ct\tAc MC11•4 1\0_ (1), being first sworn, upon oath deposes and says: Name/ laimant On or about (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 e issued to him/her in the sum of $ ) "- .(3) Signed: onz-4 (4) (5) Subscribed and sworn to before me this :220,.// day of °CI-060/ 20 110 . ,(4771 L. NOTARY PUBLIC RUTH I. WILLIS 1 COMM. #2161385 My commission expires: N tory Public • California --BAY Orange n. Expires County Ady 2). 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. Warrant/Check Number (-7o0039s(7 (if known) (6) Original Date of Issue (if known) (7) 07-2C-2-0(6 Reason for original issue of Warrant/Check (8): lr Payroll DAT,F MUiQ 7i16 111 For Services or Goods furnished Other: MtvilLOPA 0A.77_)Tir 7.3 Y 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 Application for a Duplicate or Stale-Dated Warrant/Check 460\ Affidavit/Claim Form This application is for: Ig Duplicate or El 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. Jasmine Johnson (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 9/29/2016 (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, m- 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 $ 82.39 .(3) Signed: (4) Note: Please attach a c:Opy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribed and sworn to before me this day of 19e7i',keK 20 /( . olxaki-4 sat& 111111-11 KIM PtidrACOU clitra MARICOP My commission expires: —, Com01103" may so. 20i9 "3"4 - - (seal) Warrant/Check Number 1-7-0019465 (if known) (6) Original Date of Issue 9/29/2016 (if known) (7) Reason for original issue of Warrant/Check (8): APPROVED I* Payroll DAT., ki I 2011 111 For Services or Goods furnished 4tiVillra/ 1111111/6/17. 717A..9." El Treasurer's refund/payment RK ROARD OF SUPTERVSCP 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 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: gl Duplicate or LI Stale-Dated (definitions are on page 2) STATE OF ARIZONA Numbers on this form co rrespond to numbers on the COUNTY OF MARICOPA 111 II IIII/11 is IF: 2 (o11 Hyrr Jasmine Johnson (1), being first sworn, upon oath deposes and says: iflame/Claimant On or about 10/13/2016 (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 $ 164.79 .(3) 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. (5) Subscribed and sworn to before me this -2 7 day of Ockbe--r 20 /62. Soteio 7ni NOTARY PUICIC ELIZABETH SC1113.04114ENEZ NotayRia Stake alAtana My commission expires: My MARICOPA Commission COUNTY Expires L-1 3(1 J r( May 30, 2010 (seal) Warrant/Check Number 1-7-0022655 (if known) (6) Original Date of Issue 10/13/2016 (if known) (7) Reason for original issue of Warrant/Check (8): APPROVED 110 Payroll DA-91 NOV 7..2 0 For Services or Goods furnished 0 Treasurer's refund/payment 111 Other: S1PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644