Extracted text (via pymupdf_layout)
12984 characters
INTEROFFICE MEMORANDUM Maricopa County Education Service Agency TO: Clerkof the Board FROM: Ersa Perez SUBJECT: Affidavits — Replacement of Lost /Sta1 Warrants DATE: 1/4/2016 Pase find attached _1_ AffidavitNotice of Craim(s)for Cost warrants for incrusion on the ne.4 available Board agenda. '\1 The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed- or previously re-issued: •\1 The original warrant (c) have had a stop payment done. If you have any questions, please contact Ersa Perez at (602) 506-3533 or via e-mail at garnishments@mcesa.maricopa.gov . Approved Affidavits may be routed back to the gllaricopa County Education Service Agency at 4041 W: Central-Avenue #1200, (12th Efoor) Thankyou. 'Fund: 781 .11A(1 11 GOTT $693.39 RECEP JA\I i h 2016 MN-110'0RA COLINTY CLERK ROARD OF SUPERVISORS /O, fl&4 / ee Application for a Duplicate or Stale-Datecl Warrant/Chec Affidavit/Claim form This application is for IN 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. • MATT Name/Claimant GOFF (1), being first sworn, upon oath deposes and says: On or about DECEMBER 22ND 2015 (date) (2) a warrant/check was issued to the above named person/entity in the amount as stated below. Such warrant/check was no either never received or was subsequently inadvertently lost or destroyed and there is reasonable probability of its being found or presented for payment, pi 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 $ 69339 .(3) Signed: (4) Note: Please a 11.0_a CELE evidence that a warrant/check was originally issued. U110/E orner (5) Subscribed and sworn to before me this --?/ f-7 day of Pe , -e 20 1r- . NOTARY PUBLIC DONGWU KIM NOTARY PUBLIC — ARIZONA My commission expires: My MARICOPA Commission COUNTY Expires .2C-4.2 0 1 ? May 20,201 ? Warrant/Check Number (if known) (6) 160050620 Original Date of Issue (if known' (7) 12/22/15 APPROVE Reason for original issue of Warrant/Check (8): IM Payroll O For Services or Goods furnished O Treasurer's refund/payment O Other: S: Revised \PROCESSES April 2015 \Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of ciaim - C,opy.doc A.R.S. 11-632 & 11-644 INTEROFFICE MEMORANDUM liaricopa County Education Service Agency TO: Cferkof the Ooard FROM: Erva Perez SUBJECT: Affidavits — Wcpfacement of Lost /Sta Warrants DATE: 1/6/2016 Pase find attached _1_ Affidavit/91otice of Cfaim(s)for lost warrants for inclusion on the ne4 avaira6 (Board: agenda. The attached item(s) have 6een researched to ensure that the warrant(s) in question have not 6een cashed or previously re-issued The original. warrant(s) have had a stop payment done. If you have any questions, please contact Eaa Perez at (602) 506-3533 or via e-mail- at garnishments@mcesa.maricopa.gov. Approved Affidavits may 6e routed 6ack to the Maricopa County Education Service Agency at 4041 W". Central- Avenue #1200, (12t Floor) Thankyou. Fund 781 I 0.71-X DOWDY-WE $1104.76 RECEIVED AN 07 201 6 CLERK B O A RD OF ( SUPERVISORS '' rinetti Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: • Duplicate or U 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. JOHN DONOHUE (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 24TH OF DECEMBER 2015 (date )(2) ) (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/checON issupc1 to him/her in the sum of $ 1 1 04.76 .(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)?.uyscri bed worn to b fore me this /.04±-1 day of JaAu_ctry 20 /6 . NOTARY PUBLIC tetly,„, AuteL GOMEZ-NAVARRO citify Public- State of Arizona MARICOPA COUNTY My commission e My Commission April 8,2019 Expires (seal) Warrant/Check Number 160051001 (if known) (6) Original Date of Issue 24TH OF DECEMBER 2015 (if known) (7) A Reason for original issue of Warrant/Check (8): Payroll eV/t0IP D For Services or Goods furnished MARICOr'P, COUNTY SUPERVISORS LI 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 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: 1/7/2016 Please find attached 4 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 Schools Finance Division at 4041 N. Central Avenue #1200. #216 Agua Fria Harrison Green $40.25 #66 Roosevelt Brittany Martinez De Le Rosa $1023.89 #95 Queen Creek John D O'Donnell Jr. $237.85 #68 Alhambra Lisa Catherine Greenburg $464.66 RECEIVED JAN 07 2016 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS - 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. LISA CATHERINE GREENBURG (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 12-10-2015 (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 b Lied to hi' t /her in the sum of $ 464.66 .(3) Signed: ilil) (4) (5) Sub5c4bed.a_nd sw DEF to befoJe 1.14-1 day of Jettv 0A--(2-1 20 1 . -OTAkY PUBLfC Mv c7_mtirion expires: Nobly MONICA puboc•stitscoikons LOPEZ I /'/, 20/S MARICOPACOUNTY (seal) ItConvn ......,: r Expires .11,ty 14,2011 ! 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 1 o 0 Li LI.; -12- (if known) (6) Original Date of Issue 12-10-2015 (if known) (7) Reason for original issue of Warrant/Check (8): 171 Payroll El For Services or Goods furnished BOARD OF SUPERVISORS mARICOPA COUN 111 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. jot-1 r.f D &Bj1 1-1 (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 7Yljav(- 2- 01 C (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 $ 2-37. e .(3) Signed: !c 0 (4) (5) Subscribed an sworn to efore me this 2-Z Y-8 day of-1)t . LORI ANN PLAITS Notary Put* - State dktecine My commi$sior) expires: MARICOPA COUNTY 5,1 My Commission May 2, 20190ea Emingh J 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 Lts/ (if known) (6) Original Date of Issue id._ to / --z.Of' (if known) (7) Reason for original issue of Warrant/Check (8): a Payroll 0 For Services or Goods furnished ERVISORS "OUNTY 0 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. Brittany T. Martinez De La Rosa (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 1451 (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 t inn/her in the sum of $ 1 , 023.89 .(3) Signed: - /,-,2Z-l./(4 (4) (5) Subscribed and sworn to before me ths day of JeClu-av2/ 20/4 Notary Public State of Arizona Maricopa County My commission expires: Ana My Commission A Moran Expires 07/03/2017 7/3 4/0/7 (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 16-0049756 (if known) (6) Original Date of Issue 12/24/2015 (if known) (7) Reaso/ for original issue of Warrant/Check (8): X', Payroll Eli For Services or Goods furnished , Ty "Other: E-b 11.12W ifilLe_etAeat C Cet—time- 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. HARRISON GRIFFIN (1), being first sworn, upon oath deposes and says: Name/Claimant On or about NOVEMBER 5, 2015 (date v )(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 $ 40.25 ( 3 ) Signed: 11,61fri 6e jv (4) (5) Subscribed and sworn to before me this C day of beam 122.r 20 . NOTARY PUBLIC Foredo Yale Notary Public My commission expires: C),. -as- AQI CI Marloopa County, Arizona NOVEMBER 5, 2015 MY Comm. FOres 06-2549 (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 160033722 /216695427 (if known) (6) Original Date of Issue 11/05/2015 (if known) (7) Reason for original issue of Warrant/Check (8): RI Payroll 0 For Services or Goods furnished D Other: SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999