090716 DUPLICATE WARRANTS 3 - SCHOOLS.PDF

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: 8/4/2016
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 602-506-7121 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.
#66 Roosevelt Jeanine Dougherty $327.23
RECRVED
AUG -5 2016
MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS
110 ‘pneutZ11.

AFFIDAVIT
STATE OF ARIZONA
COUNTY OF MARICOPA
7-17:2.0-c\c\c" \I being first duly sworn, upon oath deposes and says:
That on the I day of rYia04/12011, , he presented to oxeye-1. '1-11A.00 I
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of (to kt( 20 )40, said claim being in the sum of
Dollars, ($32-7.13 ) in payment of which the
Superintendent of Schools caused his/her Warrant Number 44(0- DO Igt Z,g' to be
issued on GL, , 20 L , drawn on the Fund of 0
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
41/- ob1in2.°0 in the sum of $ 32-123
Signed:
fore me this ,2q/4 day ofJWC ,20
- NOTARY PUBLIC
My commission expires: 7/ // A7/_,2(V5e'
Following approval please return this affidavit to the Maricopa County School Superintendents Office.