DUPLICATE WARRANTS - 2.PDF

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency
TO: Crerkof the Board
FROM: Essa Perez
SUBJECT: Affidavits — &placement of Lost /Sta Warrants
DATE: 2/4/2016
&ase find attached AffidavitOotice of Cfaim(s)for lost warrants for inclusion on
the next available Board agenda.
The attached item(s) have 6een researched to ensure that the warrant(s) in
question have not been cashed or previously re-issued:
The original- warrant(s) have had- a stop payment done.
If you have any questions, p lease contact Ersa Perez at (602) 506-3533 or via e-mail at
garnishments@mcesa.maricopa.gov . Approved Affidavits may be routed back to the
Ilaricopa County Education Service Agency at 4041 Central- Avenue #1200, (12'n
Floor) Thankyou.
Eund 781 REOECCA CL'OCK $900.14
— 8 2_016
ERK VISORS

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 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.
REBECCAtLUCK (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about JANUARY 7TH 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 $ 900.14 .(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 tp befor me this 3rd day of 7 20 / .
Th
NOTARY PUBLIC
DARLENE TRZEPKOWSKI
My com/is7n expires: Notary Public. State of Arizona
7,9 is' / `) My Commission MARICOPA Expires COUNTY Oct. 15, 2019 (seal)
Warrant/Check Number 160053218
(if known) (6)
Original Date of Issue 1/7/2016
(if known) (7) ell lir • - Lid al lb.& 41 It
Reason for original issue of Warrant/Check (8): FEB 9 201; ,
Payroll MrtALWALia
lii For Services or Goods furnished RK mApirnPA. BOARD OF not SUPERVISORS NTY
111 Treasurer's refund/payment
111 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

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: 2/5/2016
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 602-506-7121 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.
#44 Avondale Lauren Gomez $1181.30
#8 Osborn Joel Mills $558.97
#65 Littleton Jaime Reyna $143.88
8 2016

APPROVED
AFFIDAVIT DAT FEB 9 2016
STATE OF ARIZONA RK, BOAR OF SUP-ER ISORS
MARICOPA COUNTY
COUNTY OF MARICOPA
30CS \N./1MS , being first duly sworn, upon oath deposes and says:
That on theSI- _j c Fc.,i1EL 20 , he presented to OS\pbytt,
District of Maricopa County, Arizona, for payment, a claim for services rendered
or supplies furnished during the
month of 'W-Aber -&-- "20 L, said claim being in the sum of
-V\ sIc Cc&.-c2Nc-k-v Dollars, ($ ,S)SQ) 31 ) in payment of which the
4‘10).
Superintendent of Schools caused his/her Warrant Number (t000S I to be
issued onbrceoncir 361:- 0 la., drawn on the '3 0 Fund of ecloisv St.,1,,c36\ -1)1
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
up Do I Nt-( in the sum of .$ BOO• ti
Sign e7
Subscribid and sworn to before me this / day of L.144.GcsiA,/z,20 10
VALERIE County C of ANDERSEN ataricoPa
ConerrIsslon Coorniscloo Notary Public 1,310/22
*wpm it 40,
NOTARY PUBLIC
My commission expires: f' )2'
Following approval please return this affidavit to the Maricopa County School Superintendents Office.

AFFIDAVIT
P4-
STATE OF ARIZONA
COUNTY OF IVIARICOPA
LCUAtN -C=4Th7- being duly sworn, upon oath deposes and says:
That on the (C ( day of NMSn-IOUC-, , a015 he/she presented to
the Avondale Elementary School District of Maricopa County, for payment, a claim for services
rendered or supplies furnished during the month of NabrnbSr.-- , said claim being the
. 50(
SUM of esp_-iu-nr-A-A-A-kii tluntizai e.0141ol\gdoliars ($ t53 (J) ) in payment of which the
u
Superintendent of Schools caused his/her Warrant Number Koc-03?,()31 to be issued on
NoliErriaetc... kg, , O(5 , drawn on the rT14--0 Fund of Avondale Elementary School District of
Maricopa County, Arizona.
Claimant further says that although he/she was informed and believed that the above-
mentioned warrant was regularly issued, the same has never been received or has been lost. Under
penalty of perjury, claimant hereby affirms that this claim is correct and the amount shown is due
and owing.
Wherefore, claimant requests that the Board of Supervisors order and in the Superintendent
of Schools issue him/her a duplicate of Warrant Number •-.0 , in the sum of
t 11 $3 ( -Ric)
)/j-b--vipjf/
Claimant Signature
oxe me this cQ9 day of
My commission expires:
Seal:
NOTARY PUBLIC
STATE OF ARIZONA
Maricopa County
KAREN VELARDE
My Commission Expires 03/15/17
Following approval please return this affidavit to Maricopa County Education Service Agency

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: El Duplicate or Eli 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.
\ --Yn e (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about it / ( ,)O/ (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 $ r)V .(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.
and swoyn to before me this ,(2S, "'day of ickar L,) 20 I .
7 /
NOTARY PUBLI
ELBA M. LOZANO
Notary Public - State otArizone
My commission expires: My MARICOPA Commission COUNTY Expires
&kW n be I-- /-7 November 27, 2017 (seal)
Warrant/Check Number
(if known) (6) /6-094/06--
Original Date of Issue
(if known) (7) APPROVED
Reason for original issue of Warrant/Check (8):
IR Payroll
K. BOARD Ct SUPERVISORS
111 For Services or Goods furnished ts.AARICOPA COUNTY
111 Treasurer's refund/payment
111 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

INTEROFFICE MEMORANDUM
Maricopa County Education Service Agency
TO: Crerkof the Ooard
FROM: DEANNEWIIL
FEB- 8 2016
SUBJECT: Affidavits - Ricpfacement of Lost /Stat Warrants
ry
DATE: 2/8/2016 CLERK BOARD OF SUPLRVISORS
i LAft.....e
Pase find' attached Affidavit/Notice of Claim(s)for lost warrants for inclusion on
the next available Ooard agenda.
The attached item(s) have been researched to ensure that the warrant(s) in
question have not been cashed or previously re-issued
•Ni The original warrant(s) have had a stop payment done.
.11- you have any questions, please contact DeAnn Emil at (602) 372 -8425 or via e-mail
at garnishments@mcesa.maricopa.gov. Approved Affidavits may be routed 6ackto the
lifaricopa County Education Service _Agency at 4041 Y. Central" Avenue #1200, ( 12tfi
Ethor) Thankyou.
Fund 781 Oursey _Associates $258.69
Fund 781 Oursey es.ssociates $374.93

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: g 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.
BURSEY AND ASSOCIATES (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 24TH OF NOVEMBER 2015 f OateA2) Nf 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 $258.69 .(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 qpd sworn to before me this 21 \ day of 201(".
EttinaC
STEFANIE MEDINA
Mo mmjslioloyexpires: Notary PLOD Stile of Arizona
PIMA COUNTY
l ob My Corronassion Expires (seal)
February 21, 201a
Warrant/Check Number 160041829
(if known) (6)
Original Date of Issue 11/24/2015
(if known) (7)
Reason for original issue of Warrant/Check (8):
111 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 & 11-694

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 11 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.
BURSEY AND ASSOCIATES (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 10TH OF NOVEMBER 2015 I kdateA2) Ni 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 $ 374 . 93 .(3)
Signed: gle(/(keir-- (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 0
ST EFANIE Sto MEDINA ol Arizona
PIMA COUNTY
My cownissi9r194pires: My Febtuary C000188108 21, 2018 E8Pites
621011x (seal)
Warrant/Check Number 160036584
(if known) (6)
Original Date of Issue 11/10/15
(if known) (7)
Reason for original issue of Warrant/Check (8):
Payroll
D For Services or Goods furnished
0 Treasurer's refund/payment
LI 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

BURSEY & ASSOCIATES, P.C.
ATTORNEYS
6740 N. Oracle Rd. Suite 151
TUCSON, AZ 85704
BARRY BURSEY TELEPHONE (520) 529-3600
E-MAIL CONTACT@BURSEY.ORG FACSIMILE (520) 529-1001
TOLL FREE 1-866-629-3600
February 5, 2016
ELSA D PEREZ
4041 N CENTRAL AVE
SUITE 1200
PHOENIX, AZ 85012
I am a debt collector. This letter is an attempt to collect a debt, and any information
obtained will be used for that purpose.
Re: Case #CC2014225169RC
Dear Elsa D Perez:
Please accept this letter as confirmation that Melissa Walker is the Accounting
Manager at Bursey & Associates, P.C. and is authorized to sign the affidavit/claim form
submitted to you in regards to the above referenced case number.
Please feel free to contact me if you have any questions or need any more
information.
Sincerely,
Michelle Valdivia
VP of Administration
Bursey & Associates, P.C.