Extracted text (via pymupdf_layout)
10048 characters
INTEROFFICE MEMORANDUM Waricopa County School . Superintendent's Office TO: CLER7( TOE OOARD FROM: Willie Thompson SUBJECT: Affidavits DATE: 10/17/2016 Pase find attached 4--Affidavit/Yotice of Craim(s)for Cost warrants for incrusion on the noct avaiCa6Th Ooard agenda The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previous fy re-issued The original-warrant(s) have had a stop payment done. If you have any questions, 1:)cise contact Mew 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 Central Avenue #1200, ( 12 th ECoor) Thankyou. # 201 (UCKETE V3VION . KARLEE MILLER $402.11 34isz_ /(--( id4 go 3'91 , 01 7 SORS AFFIDAVIT APPROV E.i) AT 10 t„_ / ...... STATE OF ARIZONA W. dinifSr COUNTY OF MARICOPA TD CnrtK, MARICOPA BOARD OF COUNTY SUPERVISORS -- '<ARLIE M I LLE.P. , being first duly sworn, upon oath deposes and says: That on the 2.614/dav of SEPr 2016 , she presented to 6ockENIg UNION AiGH C14001,- District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of SE Fran BER 20 , said claim being in the sum of Fultz. 41..tnion..D Two 4 Moo —Dollars, ($ 402. II ) in payment of which the Superintendent of Schools caused his/her Warrant Number ZO l(ol 69678 to be issued on SEPTEm8ER 23 ", 20161 , drawn on the DO( Fund of 80a,VE UNION HIGH District of Maricopa County, Arizona. Affiant further says that although he/she 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/her a duplicate of said Warrant Number 2oio rip g78 in the sum of $402, 11 . 1 LESLIE DOUD Notary Public • Arizona I, Signed: My Comm, Maricopa Expires County Nov 14, 2017 Subscribed and sworn to before me this a IC K day of , My commission expires: )1 (-1130/ NOTARY PUBLIC Following approval please return this affidavit to the Maricopa County School Superintendents Office, 1 AFFIDAVIT STATE OF ARIZONA COUNTY OF MARICOPA CLERK MARICOPA BOARD OF COUNTY SUPERVISORS * i I M IVO,WD , being first duly sworn, upon oath deposes and says: (name and title of person )* That on the 7-7-1./ day of eTt-n3E/2-. 20 I , he/she presented to s z. District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of Jtj 1 y 20 I (.0 , said claim being in the sum of ($ 89 I .X7 1 1A-A-- 1,1 uek d re A /I( Netti - DAL C.10( ta(S 4:1" ildef4y-0110,04Dollars in payment of Which the Superintendent of Schools caused his/her Warrant Number I - 7 -6060 I(olio to be issued on the si u y 7 4-% ,20 , drawn on the 00 t Fund of oals Si) 4-31 District of Maricopa County, Arizona. Affiant further says that although he/she 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/her a duplicate of said Warrant Number I - 7- (no° wo in the sum of $ 9 I d7 . Signed:** 'c/Vbta--- (Name & title of authorized personnel)** Subscribed and sworn to before me this 7-r1.4 day of 0 , 20/L COMMONWEALTH OF PENNSYLVANIA NOTARY PUBLIC : NC1TAPito SEAL Jacqueline A. Smith, Notary Public My commission expires: AUG 9 Bethel Park Boro, Allegheny County My Commission Expires Aug. 4, 2019 MEMBER, PENNSYLVANIA ASSOCIATION OF NOTARIE Following approval please return this affidavit to the Ma ricopa County Education Service Agency Office. 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: 10/17/2016 Please find attached 3 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. #68 Alhambra Connie Ramos $159.46 #68 Alhambra Madeline Robinson Spuggins $109.09 #68 Alhambra Karen Frusti $247.23 OCT ?016 CLERK BOARU DIVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: El Duplicate or El Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the 9OUNTY OF ICOPA Instruction sheet which is page 2 of this form. (11PIC Ctale-D (1), being first sworn, upon oath deposes and says: Name/Claimant On or about A I- 1c1 - 2- 0 1 5- (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 befsuecl to him/Joefin the sum of $ 159, 4-710 .(3) Signed: / fl /(,(11f€,' ( (4) Note: Please( atta-cc a co' ii177-or- - 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 741' day of UQ.,-@--60e)( 201(0 . NOTARY PUBLIC • "44! AURA OFFICIALSEAL NELSON j My commission expires: 11:6r.:41 Notary Public - State of Arizona • tobie• MARICOPA COUNTY (seal) !IOW' My Comm. Expltets Dec. 28, 2019 ! Warrant/Check (if known) Number (6) /0 00 FrD (06' Original Date of Issue (if known) (7) .1 V Reason for original issue of Warrant/Check (8): Payroll El For Services or Goods furnished LI 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 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: El 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), being first sworn, upon oath deposes and says: On or about II - 19- (%16--- (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/clAeOk b iss,u4:1 to hipT/her in the sum of $ /09 . Oq .(3) Signed: % (,& JI1 55,a4. (4) Note: Please attach a cop of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribedxid sworn to before me this day of 62/61-1e-i 20 /_((-/- . N 01A RY/PT43(1-1C OFFICIAL SEAL M)i)cornmission expires: , i Notary LAURA Public - State VERA of Arizona ,fic /6 c.3/i c-A24/7 MARICOPA COUNTY (seal) My CommEs Aug. 31, 2017 Warrant/Check Number /(0960 89)&9 (if known) (6) Original Date of Issue (if known) (7) Li V Reason for original issue of Warrant/Check (8): DAT LA. Payroll ERK, BOARD OF SUPERVISORS 0 For Services or Goods furnished MARICOPA COUNTY II Treasurer's refund/payment 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 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: El 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. 16reel TsuC (1), being first sworn, upon oath deposes and says: Name/Claimant On or about / 2// 7 /5 (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 $ ,;z 1/7, .(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 pnd sworn to befoye/Me this '()7/day of .)6_ 20 OFFICIAL SEAL iz,KLwi,,. LAURA VERA lly commissiowxpire,s: Notary Public - State of Arizona •i MARICOPA COUNTY )// My Comm. Expires Aug. 31, 2017 ! (seal) Warrant/Check Number ItnooLfefiv138/ (if known) (6) Original Date of Issue (if known) (7) Reason for original issue of Warrant/Check (8): la Payroll D For Services or Goods furnished El Treasurer's refund/payment III 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