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CLE RK 7) . BOAR MARICOPA PE RY ISQR'S Maricopa County c 0 UNT Y Human Resources Department 2015 MAR 3! P M 2 04 Payroll & Employee Records Division 301 West Jefferson Street Suite 220 Phoenix, AZ 85003-2143 Phone: 602-506-3519 Payroll Fax: 602-372-0277 Records Fax: 602-506-5509 Wwiw.maricopa.gov To: Fran McCarroll, Clerk of the Board From: Wanda Childers Lo Date: March 31, 2015 Re: Replacement of Lost Payroll Warrants Please find attached _ 2 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 __ Wanda at x 6-0409 for any questions. Please route approved Affidavits back to County Payroll, Suite 220. Thank you. K BOARD OF SUPERVISORS ~ AFFIDAVIT/NOTICE OF CLAIM | MARICOPA COUNTY 7 ~ RECEIVED STATE OF ARIZONA 2015 MAR 30 P & 04 COUNTY OF MARICOPA : Enea Kiuroear BEING FIRST DULY SWORN _____ OATH, DEPOSES AND SAYS: Thatonthe 3b dayof Méecen ,20 1S, he/she presented — — to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of Mager said claim being in the sum of , [a Cieny qu roses fitTy Treo paras ANS Foo Dollars ($ 8S2.43 ) in payment of which the Board of Supervisors caused the Warrant No. OG 22266600 to be issued on Magen ZS ,20 IS 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. 60222€640 © Inthe sumof$ SS 2.43 4-a— Dated: MaAecty SO .201S Signed: _ — A ffiant *** A $12.00 fee for the stop payment and reissuance of the warrant will be deducted from the replacement check.*** Subscribed and sworn to before me this 2c day of Mow 20 \I5 , EILEEN WILLIAM Notary Public - State of Artzona Nptary Public : My commission 4¥ MARICOPA COUNTY | a? ovember ber 9, 9, 2018 \\- 9-20 UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: AFFIDAVIT/NOTICE OF CLAIM h } PERVISORS | RECEIVED STATE OF ARIZONA COUNTY OF MARICOPA ais HAR 30 P OU A COUNTY MAT HEevo Fao Beets BEING FIRST Re VORECORDS OATH, DEPOSES AND SAYS: That on the 2cott day of (c \A\ et al 20 (> he/she presented , , to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of [-\C)\ eett said claim being in the sum of , _— wt . ese OWE THhoo~m@np ve Htowpzed SeveuTy CiG tT nollnec “i 7! ‘ Dollars ($45 ) in payment of which the Board of Supervisors caused the Warrant No. 299 (ylelo (S_ to be issued on MHACCH & Sa 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 ol Warrant Nodg2lputp 15. In the sum of $ |, 528. Dated: MAveck 25 20157 Signed: , Qt UR Affiant *** A $12.00 fee for the stop payment and reissuance of the warrant will be deducted from the replacement check. *** 30 May- | 5 Subscribed and sworn to before me this day of a0 EILEEN WILL ; cay Mle teen Ub ons eONT w=) » : MARICOPA COUNTY Notary Public My Commission My commission November 8, tee lt -G -QOIY UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: