Extracted text (via pymupdf_layout)
3846 characters
MARICOPA COUNTY 804RD OF CLERK Department of Finance FIARICOIDA SUPERVISOR'S COUNT Y 301 West Jefferson, Ste 960 2016 JAN -6 PH 1:55 Phoenix, Arizona 85003 inaivi cloia ett-4 INTEROFFICE MEMORANDUM Date: January 6, 2016 To: Clerk of the Board From: Beth Brown Department of Finance Subject: Affidavit — Notice of Claim Please find attached Affidavit for stale dated warrant to be included on the next available Board Agenda. • The attached item has been researched to ensure that warrant in question has not been cashed or previously re-issued. • The original warrant has a void/stale date/stop payment done. Please call me at 506-1329 if you have any questions. Please return the approved Affidavit to my attention in the Department of Finance, Suite 960. Thank you. Re: AARON LUTZ Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: 0 Duplicate or Fl Stale-Dated (definitions are on page 2) STATE OF-AREDNA , Note: Numbers on this form correspond to COUNTY OF -MARICOPA (-- numbers on the Instruction sheet which is bade 2 of this form. AARON LUTZ (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 08-Jul-2014 (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/ch9C issued to him/her in the sum of $ 95 .20 .(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 to before me this day of 20 My commission expires: (seal) Warrant/Check Number 350000458 (if known) (6) Original Date of Issue 08-Jul-2014 (if known) (7) Reason for original issue of Warrant/Check (8): 0 Payroll 111 For Services or Goods furnished 0 Treasurer's refund/payment Other: refund - court case was dismissed Page 1 of Warrant 3-5-0000458 Details Wt Number 3-5-0000458 Wt Amount $95.20 Wt Status STALE CANCEL/VOID Wt Interest 0 Acct Num 31-767-000 Issue Date 7/8/2014 Paid Date 7/31/2015 Register Date Voucher 000 Claim Number 000000 PO Num 000000 Fund Number 767 Dept Num 0000 Low Orig 00000 Payee AARON LUTZ Sub Fund 000 Return to Warrant Lookup Return to Finance Functions Help for this page rttps://treasurer.maricopa.gov/Agency/FinanceFunctions/wtlookup.asp 1/6/201( (A) Secure , Telnet - PASSPORT Wednesday, January 06, 2016, 13:02:30 PM ACTION: R SCREEN: WREC USERID: MARB 01/06/16 12:35:18 PM WARRANT RECONCILIATION ( 1 OF 2 ) BANK ACCOUNT CODE= 01 WARRANT WARRANT NO FUND VENDOR NAME DATE AMOUNT AD00350000458 100 AARON LUTZ 07 08 14 95.20 07 31 15 AD00350000459 100 ALEXANDER HARDIN 07 08 14 441.50 09 08 14 AD00350000460 100 ANDRES MIGUEL ANDAVERD 07 08 14 50.00 07 15 14 AD00350000461 100 BERTHA G AVILA 07 08 14 410.00 07 15 14 AD00350000462 504 BILL BOUCK REPAIR 07 08 14 50.00 07 14 14 AD00350000463 504 BRINKMANN CONSTRUCTORS 07 08 14 530.00 07 15 14 AD00350000464 504 GENERAL ACRYLICS INC 07 08 14 1,325.00 07 14 14 AD00350000465 504 HOLLY STREET PROPERTIE 07 08 14 430.00 07 14 14 AD00350000466 100 KEVIN TARNOWSKI 07 08 14 336.00 07 31 15 AD00350000467 100 MARC ALEXANDER HOWLETT 07 08 14 240.00 11 17 14 AD00350000468 504 MTN STATES CONTRACTING 07 08 14 530.00 07 14 14 AD00350000469 504 NORICK CONSTRUCTION LL 07 08 14 795.00 07 11 14 AD00350000470 504 PORTER BROTHERS 07 08 14 975.00 07 15 14 AD00350000471 504 REXAM BEVERAGE CAN CO. 07 08 14 217.80 07 31 14