100516 DUPLICATE WARRANTS 3 - SCHOOLS.PDF

INTEROFFICE MEMORANDUM
Waricopa County School -Superintendent's q
TO: CCER2(0E Da' 00ARD
FROM: gtliftie Thompson
SUBJECT: Affidavits
DATE: 9/16/2016
Pase find attached 3 AffidavitOotice of Craim(s)for Cost warrants for incrusion on
the next avaiCabfe Woard agenda
The attached item(s) have been researched to ensure that the warrant(s) in
question have not been cashed or previousCy re-issued
The original. warrant(s) have had a stop payment done.
If you have any questions, Aase contact Millie (Thompson at 506.3898 or via e-maiC at
mthompson@mcesa.maricopa.gov . Approved Affidavits may be routed back to the
Superintendent of School . finance (Division at 4041 W. Central. Avenue #1200, ( 12 th
Efoor) Thankyou.
#1 oforEgax ELE11 AS.7 fLET ZECIf $30.26
#60 NIGLET TEETH" MDE $ 71.44
#60 IfIGLET AgvIAN -QA wrILLIps $240.00
2_ 0
CLERK B

d o &s AffidavitICai
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.
Fleet Pride (1), being first sworn, upon oath deposes and says:
Namo/C1, aimant
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 be issued to him/her in the sum of $71 .44 .(3)
Signed: (4)
5) Subscribed and sworn to before me this day o ae,pltmke.AP__ 2011i_
NOVARY PUBLIC JOANNA SANCHEZ
NOTARY PUBLIC - ARIZONA
Maricopa County
My commission expires: My Commission Expires
ony,inj 1001.'1 February 21,2019 (seal)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was on:ginally issued.
Warrant/Check Number 460077944 FA 44) IL' D.
Jif known) (6) bEr • .‘•o--nt
1 Original Date of Issue 2/29/2016 DAT
(if known) (7)
CLERK. MARICOPA BOARD OF COUNTY SUPERVISORS
Reason for original issue of Warrant/Check (8):
El Payroll
A For Services or Goods furnished PaA .+-S
El Other:
SAPROCESSES \Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc A.R.S. 11-632 & 15-999
Revised June 2015

1 WI • .-.._,..t..11G1M356.--,-...1 ",--arnammn,
Flopirri RECEIVEDBYHUSD
SEP 0 9 016
Henry Ihdy
FINANCIALSERVICES
151, 7.7-777
1801 N. Black Canyon Hwy, Phoenix, AZ 85009
602-258-8851 Fax 602-252-3725
Parts Direct 800-224-2444
September 7, 2016
Higley Unified School District
2935 S Recker Rd
Gilbert, AZ 85295
Attn: Lisa Bate
Re: Loss Check
Lisa,
I have enclosed the affidavit that has been notarized. This letter is to verify that Bob Shoufler is the
Branch Manager at the FleetPride at 1801 N Black Canyon Highway in Phoenix AZ and is authorized to
sign the affidavit.
Please have the replacement check for $71.44 sent to:
FLEETPRIDE
PO Box 847118
Dallas, TX 75284-7118
Thanks for your assistance in having this payment processed.
Sincerely,
Dee Polito
Account Service Rep
FleetPride
602-258-8851
Dee.Polito()fleetcride.corn

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.
Amanda Phillips (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about til (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 iss to him/her in the sum of $ 240.00 .(3)
Signed: ' (4)
(5) Subscribed and sworn to)ifore me this I 5 day of S-e_f+- 20 1
NOTARY PUBLIC
My commis ion expires: AIMEE E POMONIS
5/1 5 2-02-Z) Notary Maricopa Public, State County of Arizona (seal)
My Commission Expires
tel:a2441:82:13
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 470007371
(if known) (6) LPP e‘, ROvE ICI
Original Date of Issue 07/28/2016
(if known) (7) - uN9,0 2016
Reason for original issue of Warrant/Check (8):
El Payroll K. MARICOPA BOARD Ot- COUNTY SUPERviSORS
For Services or Goods furnished
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

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.
Ashley Zech (1), being first sworn, upon oath deposes and says:
Name/Ciaimant
On or about May 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, pr. 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 $ 30.26 .(3)
Signed: (4)
(5) Subscribed and sworn to before me this 45/4\ day of pl-arn40)20_1(0.
j1.12ek n C
NOTARY PUBLIC
My commission pxpirps: rioRtAaryNC !. RIVAS
M'a4/4-11-2e+e. i/ 311 >i) Maricopautolcu. Arizonat (seal)
Expires 01/31/2t1120
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 460109871
(if known) (6)
Original Date of Issue 06/09/16 A P - 1". -- vr v,' n D
(If known) (7) '
Reason for original issue of Warrant/Check (8):
0 Payroll
0 For Services or Goods furnished
/1 Other:
S: \PROCESSES \Warrants - Duplicate or Stale\02 Forms \Schools\Schools-Warrants Checks notice of clalm.doc
Revised June 2015 A.R.S. 11-632 & 15-999