STALE DATED WARRANT - 3_REDACTED.PDF

MARICOPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: January 26, 2016
C.-.
To: Clerk of the Board
0-1
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: GERALD OKONESKI REVOKABLE TRUST

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form
This application is for: 0 Duplicate or 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.
it— C (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about /2- (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 $517(2., - .(3)
Sign (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) Subscri and sworn to before me this (21 -"day °rt.., 20
Ag
he.1. AZrAr
e • PI IRI T( FRAN MCCARROLL
Notary Public - Stale of Arizona
MARICOPA COUNTY
y commission expires: My August Commission 28, 2019 Expires
(seal)
Warrant/Check Number
(if known) (6) .81 175
Original Date of Issue
(if known) (7) -03 'ZCN
Reason for original issue of Warrant/Check (8):
0 Payroll
El For Services or Goods furnished
_Treasurer's refund/payment
El Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim.doc
Revised April 2015 A.R.S. 11-632 & 11-644

JPMargan Chase Bank. N.A.
MARICOPA COUNTY TREASURER PHOENIX. AZ 816873
CHARLES "HOS" HOSKINS, COUNTY TREASURER ACH 122100024 816873 !
SERVICING BANK ACCOUNT 91-2/1221
3
1M3/2014 6
PAY
479 Dollars and 48 Cents $479.48
deCi.
mclil
TO THE ORDER OF
GERALD OKONESKI REVOKABLE TRUST CHECK VOID AFTER 365 DAYS res
MARICOPA COUNTY TREASURER Featu
CHARLES "HOS" HOSKINS, COUNTY TRkASURER
security
MEMO AUTHORIZED SIGNATURE
012, 1,68710 L 22 L0002 10: 9000 L140 Le
DETACH AND RETAIN THIS STATEMENT
THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW. IF NOT CORFIECT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DESIRED.
DATE DESCRIPTION AMOUNT
Mortgage Rejects - see attached list
TAX YEAR - 2014, MORTGAGE CODE - 1)101
12/03/2014 816873 SLIP 201400728 CHECK TOTAL; $479.48
HARLAND CLARKE M2045 40238114 MARICOPA COUNTY TREASURER
CHARLES "HOS" HOSKINS, COUNTY TREASURER 816873
SERVICING BANK ACCOUNT

Couli m 0
Disburse
Maricopa
1
EXCEPTION
816873 1243/2014 STALE CHECK NO REFUNDS
PM
TREASX 2016 1:35 Warrant/Check
- 26,
Benton January - FINX Dated
Chavez Brown Statle TRUST
Isela Tuesday, Beth RE:
462762 REVOKABLE
FINX Detai Detail
- Number: Status: To: OKONESKI
Brown Disbursement 1-leip Disbursement Date; Current Medium: Reissued Exception GERALD
Beth From: Sent: To: Subject: Fire Check Issue Type: Payee

Current User D101 Maiiropa County Treasurer's
GERALD OKONESKI rrin S.emiceR., ql/9.±m1
REVOKABLE TRUST EXCEPTION
NUMBER NUMBER
YEAR C OWED
Loa' Out PAID AMOUNT TYPE
REASON
Batch Payment Processing
Statement Request List Format
Upload Statement Request List
Statement Recuest Status Report
Oueue
Generate Payment List
Payment List Queue
OVERPAYMENTS:
Upload Payment List 0 .00
Payment Status Report Queue
Remittance Voucher UNDERPAYMENTS:
Check 0.00
Wire/ACH PROGRAM ID: CSH
FINISH MTG _ BATCH POSTING
Exception/Rejection Report 07-NOV-2014
Queue
MARI COPA C
Account M aintenance OUNTY TREASURER'
S OFFICE
Account Requests in Queue: 40 PAGE: 2
Generate Account List
Account List Queue BATCH REJECTED PAYMENTS REPORT
PAYMENT DATE: 23-OCT-2014
Add Statement Request Manually
Delete Statement Request TRANSACTION: MO-D101
Manually
GERALD OKONESKI REVOKABLE
3f011»11 don TRUST
Prior Years Requests Queue
Tax Bill Print Status
Print Tax Statement: (Y)
Print Info Stattnent: (Y)
User Profile LOAN PARCEL
TAX
Announcements AMOUNT TRANS
EXCEPTION
Glossary of Terms A NUMBER NUMBER
Dates to Remember YEAR
Parcel Inquiry

Charles "Hog" Hoskins, Treasurer
301 West Jefferson St., Rm.100
Phoenix, Arizona 85003
Maricopa County Phone: Fax: (602) (602) 506-1102 506-39'75
Treasurer http://treasurer.rnarieopa.gov
December 3, 2014
GERALD OKONESKI
GERALD OKONESKI REVOKABLE TRUST
Subject: Reject/Exception Refund check(s); D101
Dear GERALD OKONES1CL
Enclosed are the following:
- Refund check for rejected current 2014 property tax payments
- Reject / Exception report with rejected current tax payment reason codes
If you have any questions, please contact Corporate Service by e-mail at
css@mail.maricopa.gov or by phone at (602) 506-6052.
Sincerely,
Glen Ahrlich
Corporate Services Specialist

PROGRAM ID: CSH FINISH_MTG_BATCH_POSTING 07-NOV-2014
MARICOPA COUNTY TREASURER'S OFFICE PAGE:
BATCH REJECTED PAYMENTS REPORT
PAYMENT DATE: 23-OCT-2014
TRANSACTION: MO-D101
GERALD OKONESKI REVOKABLE TRUST
LOAN PARCEL TAX 14 AMOUNT TRANS EXCEPTION
NUMBER NUMBER YEAR PAID TYPE REASON
CAMPOS L 102-79-718 6 2014 1 479.48 06 030
I• IIII ......a... IIIIIIII- IIIII •II..=== II u I. IIIIIIIIIIIIIIII ...=
REJECTED PAYMENTS: 479.48
TOTAL REFUND: 479.48
EXCEPTION REASON DESCRIPTION
****************************
001 INVALID PARCEL, CONTACT ASSESSOR
004 2ND HALF PAYMENT WITH FIRST HALF DUE
013 PROBLEM WITH PAYMENT, CONTACT OUR OVVICE
019 OVERPAYMENT
020 UNDERPAYMENT
024 RESOLUTION PENDING, CONTACT OUR OFFICE
030 TAXES ALREADY PAID
031 TAX LIEN EXISTS
034 TAX LIEN PENDING

PROGRAM ID: CSH FINISH_MTG_BATCH_POSTING 07-NOV-2014
MARICOPA COUNTY TREASURER'S OFFICE PAGE:
BATCH REJECTED PAYMENTS REPORT
PAYMENT DATE: 23-OCT-2014
TOTAL OVERPAYMENTS: 0.00
TOTAL UNDERPAYMENTS: 0.00
TOTAL REJECTED PAYMENTS: 479.48

PROGRAM ID: CSI FINISILMTG_RATCH_POSTING 07 -NOV -2014
MARICOPA COUNTY TREASURER'S OFFICE PAGE: 1
BATCH EXCEPTIONS REPORT
PAYMENT DATE: 23-OCT-2014
TRANSACTION: MO-D101
GERALD OKONESKI REVOKABLE TRUST
LOAN PARCEL TAX TAX AMOUNT OVER/UNDER TRANS EXCEPTION
NUMBER NUMBER YEAR C OWED PAID AMOUNT TYPE REASON
OVERPAYMENTS: 0.00
UNDERPAYMENTS : 0.00