050615 DUPLICATE WARRANTS - 3.PDF

MAR1COPA COUNTY
Department of Finance
301 West Jefferson, Ste 960
Phoenix, Arizona 85003
INTEROFFICE MEMORANDUM
Date: April 21, 2015
To: Clerk of the Board
From: Beth Brown
Department of Finance
Subject: Affidavit — Replacement of Lost Warrant
Please find attached affidavit for lost warrant to be included on the next available Board
Agenda.
• The attached item has been researched to ensure the 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: Arnold Turer
RECEIVED
APR 2 1 2015
mARIcom COUNTY
CLERK BOARD OF SUPERVISORS

APPROVED
DATE, APR 4 2615 RECEIVED
tvIARICOPA COUNTY ORS AFFIDAVIT APR 2 0 2015
RISK MANAGEMENT
STATE OF ARIZONA,
COUNTY OF MARICOPA
ARNOLD TURER, being first sworn, upon oath deposes and says:
That on the 20th day of March, 2015, Maricopa County agreed to an Indemnity
payment, in the sum of One Thousand Twelve Dollars and Zero Cents, ($
1,012.00) in payment of which the Board of Supervisors caused the Warrant
No.AD 00350023856 to be issued on March 20, 2015, drawn on the Expense
Fund.
Affiant further say that although they were informed and believe that the above
mentioned warrant was regularly issued, the same has never been received, or
has been lost.
Wherefore, affiants pray that the Board of Supervisors issue to them a duplicate
of said Warrant No.AD 00350023856 in the sum of $1,012.00.
a
Signed:
Subscribed and sworn to before me this Vi 'day of
OTARY PUBLIC
My commission expires: N1A (/
Return original signed, notarized form to: lemaridariarrilairdlr.d 164
Maricopa County-Risk Management Dept. Nctary ERIC Public SYLVE - Arizona
222 N. Central Avenue, St., #1110 My Comm. Maricopa Expires County May 11, 2018
Phoenix, AZ 85004