Extracted text (via pymupdf_layout)
2130 characters
Maricopa County Human Resources Memo To: Fran McCarroll, Clerk of the Board From: Linda Widner Date: May 28, 2015 Re: Replacement of Lost Payroll Warrants Please find attached 1 Affidavit/Notice of Claim(s) for lost payroll warrants for inclusion on the next available Board 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. Please call Linda Widner at ext. 6-8051 for any questions. Please route approved Affidavits back to County Payroll, Suite 220. Stale Dated Warrant / Duplicate Warrant Thank you. 1RECEIVED MAY 2 9 Z015 MAR1COPA COUNTY CLERK BOARD OF SUPERVISORS 1040r 64 ,fic-e ci% APPRCii M AFFIDAVIT/NOTICE OF CLAIM ERK, BOARD OF SUPERVISORS MARICOPA COUNTY RECEIVED STATE OF ARIZONA COUNTY OF MARICOPA 11115 NAY 28 A 10: 21 MAR1COPA COUNTY /s.4e /49) BEING FIRST DULY SWWOLURECORDS OATH, DEPOSES AND SAYS: That on the 2 ) day of mz , 20 /'), he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of , said claim being in the sum of hilehd AaiRK 7)4, 7ro//&4f. Dollars ($ g q'tf ) in payment of which the Board of Supervisors caused the Warrant No. 2,22 7 .VY7 to be issued on /nay .2_0 , 20 / 5 , drawn on the Payroll Clearing Account fund. 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. Under penalty of perjury, affiant hereby affirms that this claim is correct and the amount shown is due and owing. WHEREFORE, affiant requests that the Board of Supervisors issue to him/her a duplicate of said Warrant No. ..20.2c2 In the sum of $ Dated: 5- - ,20 )5 Signed: (-4. Affiant for-the-stap-paym az_auc replacement-check *** 00- r---tk9R1M:R91W I•IL'I .. PA 1 to before me this E"U day of 20 1 Notary Public - State te of Arizona MARICOPA COUNTY My Commission Expires November 14.2016 Notary Public. My commission expires: NOV , /4 c:1DI5 UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: