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INTEROFFICE MEMORANDUM Ilaricopa County Scitoot"Superintendent's TO: CLERK OE ME 00.XR9) FROM: Willie Thompson SUBJECT: Affidavits DATE: 12/8/2015 Pase.find attached 1 Affidavit/i1rotice of Claim(s)for lost warrants for inclusion on the next available oard agenda The attached item(s) have been 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, please contact Willie Thompson at 506.3898 or via e-mail at mthompson@mcesa.maricopa.gov . Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4041 N. Central- Avenue #1200, ( 12 th Efoor) Thankyou. #68 AO -LAMM 51/1A GVADALVPE CASTRO $1034.61 A RECEIVED DEC 0 8 2015 MARICOPA GOIJI IfiN 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. rig ) (1), being first sworn, upon oath deposes and says: aCm On or about /// /7 /IS (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 pei jury, claimant hereby affirms that this claim is correct and the amount shown is due and owing, and the applicant requests that a repl cement , --, --A- warrant/check be issued to him/her in the sum of $ .(3) Signed: qeet -ea,A471-4V (4) (5) Subscribed and sworn to before me this / 7 46 day of 20 /.( NOTARY PUBLIC' Jennifer Emery Notary Public My commission expires: Maricopa County, Arizona c_D /6 My Comm. Expires 4-30-16 (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 (if known) (6) I (ObC) Original Date of Issue 61/3/Zo 15- (if known) (7) Reason for original issue of Warrant/Check (8): 1,, Payroll C741"V 111 For Services or Goods furnished EPA, MARICOPA BOAR-D OF COUNTY SUPERVISORS LI 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 Warrant Display Page 1 of 1 Warrant 1-6-0015225 Details Wt Number 1-6-0015225 Wt Amount $1,034.61 Wt Status OUTSTANDING Wt Interest 0 Acct Num 33-030-068 Issue Date 9/3/2015 Paid Date Register Date Voucher 614 Claim Number 000614 PO Num 000000 Fund Number 030 Dept Num 3700 Low Orig 00000 Payee CASTRO, MA. GUADALUPE Sub Fund 000 View Audit History Image is not available on the web. Warrant Search Return to List of GL Accounts Help for this page https://treasurer.maricopa.gov/Agency/AccountInquiry/WarrantDisplay.asp?warrantnum.. . 11/19/2015