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INTEROFFICE MEMORANDUM Ilaricopa County Education Service Agency (aka Ilaricopa County Superintendent of Schoors. Office) TO: CLERK OF TJTE 00ARD FROM: Willie Thompson SUBJECT: Affidavits — Wfpfacement of Lost Warrants DATE: 3/10/2015 Pease find attached 2 Affidavit/Notice of Craim(s)for Cost warrants for incrusion on the next avaira& Board agenda 'The attached item(s) have heen 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 Wiffie 'Thompson at 506.3898 or via e-mail at mia.thompson@mcesa.maricopa.gov . Approved Affidavits may he routed 6ackto the Superintendent of School 'Finance (Division at 4041 Central- Avenue #1200, ( 12en 'Floor) ghankyou. #65 .L.FITLETON AWANDA GONZALEZ $299.21 #68 ALY -fA.9140Wil ACCEL sumac uvc $29250.00 RECEIVED MAR 1ff 2015 MARLCOP,li JiTy CLERK BOARD OF 2UPERVISOBS Stop Payment 2 4,411101 .41•sciio° Affidavit Business Resources STATE OF ARIZONA -k APPROVED "AR 1 3 2015 COUNTY OF MARICOPA DALE Amanda Gonzalez , being first duly sworn, upon oath deposes and states: That on the 2 day of March , 20 15 , he/she presented to Littleton Elementary School District No. 65, of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of June , said claim being in the sum of Two Hundred Ninety Nine & 21/100 Dollars ($ 299.21 ) in payment of which Littleton Elementary School District No. 65 caused warrant/check number 140102304 to be issued on 30 day of June ,20 14 drawn on the warrant/check fund of Littleton Elementary School District No. 65 of Maricopa County, Arizona. Affiant further states that although he/she was informed and believes that the above mentioned warrant/check was regularly issued, the same has never been received, or has been lost. Wherefore, affiant requests that the Governing Board order and the Littleton Elementary School District No. 65 issue to him/her a replacement of said warrant/check number 140102304 in the sum of $ 299.21 Signature Subscribed and sworn before me this day of (\ACnrch , 20 J 5 . Signature of Notary Public Ada C. ClIlls Notary Public-Arizona Madoopa County My Comm. Expires July 31, xna My Commission Expires 03/2013 A MAR 3 11115 DA AFFIDAVIT Lix;(11-#49 STATE OF ARIZONA COUNTY OF MARICO PA * ()free\ <(6\0A TIrc , being first duly sworn, upon oath deposes and says: (name and title of person )* p IYI That on the C-1 day offr5_0— fLi , he/she presented to District of Maricopa County, Arizona , for payment, a claim for services rendered or s upplies furnished during the month of AO-r -.-. *)....-- 20 ILA , said claim being in the .o, sum of ($41 ,P..co.c:11 vAim ' --`0c-1c-rt-A .-\--L)-c, Y\LI,c\rerA .e..C\-, —67. t Dollars in payment of ...) .._) Which the Superintendent of Schools caused his/her Warrant Number 4-)..S.00c( d9,\ to be Issued on the - q ,20 )LI , cirawn on the d-) Fund of District of Marlcopa County, Arizona. 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. WHEREFORE, affiant prays that the Board of Supervisors order and the Superintendent of Schools issue to him/her a duplicate of said Warrant Number (-LS-Cd-hcnl in the sum of Signed:** SA3m(t/11- L-7 'Lame & title of authorized personnel)" - Pt. Subscribed and sworn to before me this 623' V_Aday of NOTARY PUBLIC: NICOLE M. NELSON My commission expires: Fe17.,:v6,0/6 Notary PublIc,Stale of Arizona Maricope County My Commission Expires February 26, 2016 Following approval please return this affidavit tr, the Maricopa County Education Service Agency Office. MARICOPA COUNTY Department of Finance 301 West Jefferson, Ste 960 Phoenix, Arizona 85003 INTEROFFICE MEMORANDUM Date: March 11,2015 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: Village People's Block Watch ECEIVED MAR I I 2015 MARICOPA L:20UNTY CLERK a0A1lD OF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: Duplicate or 0 Stale-Dated (definitions are on page 2) Note: Numbers on this form correspond to STATE OF ARIZONA numbers on the Instruction sheet which is COUNTY OF MARICOPA page 2 of this form. Village People's Block Watch (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 24 -Sep -2014 (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 reasonable probability of its being found or presented for payment, or it was not no 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 i e sum of $ i50.00 .(3) (4) Signed: Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribed and sworn to before me this day of 4i CI-/ 20 LS: NOTARY PUBLIC Notary Public State of Arizona Maricopa County My commission expires: My Brigitte Commission L Campbell Expires 04/29/2017 . tx 4:2-7/7 / w WwWW Warrant/Check Number 350007550 (if known) (6) Original Date of Issue 24-Sep-2014 (if known) (7) Reason for original issue of Warrant/Check (8): LI Payroll 0 For Services or Goods furnished rzi 0 Treasurer's refund/payment _ Other: Elections rental fee '.0 MAR 131415 CLL BK. BOARD OF SUPERVISORS MARICOPA COUNTY Page 1 of 1 Warrai4 Display 3-5-0007550 Details Warrant Wt Amount $150.00 3-5-0007550 Wt Number OUTSTANDING Wt Interest 9/24/2014" Wt Status 31-767-000 Issue Date Acct Num Register Date 000000 _ Paid Date 000 Claim Number 767 Voucher 000000 Fund Number, 00000 PO Num 0000 Low Orig 000 Dept Num , PEOPLE'S BLOCK Sub Fund Payee VILLIAGE View Audit History . Image is not available on the web. Warrant Return to Search List of GL Accounts Help for this paee qtioc . / rAva—E-. c.:7) 06\1 1 1 /1 Rt7.01 4 TREASURER OF MARICOPA COUNTY WgM.tOr PHOE :NrX, ARiZONA 09(24/2i Q0350007550 *CN37 HUNDRED 1-1 7TY DOLLARS AND s ** 15D.00 PA"( 10 11-i V7L-rrACT'r PECPLE'S IBLOC WATCH 1725 N 7TF ST *5S PHCENTX Al ,S5022 QUESTTONS — 602 —.E.0E —497.6 NOT NEGCnABLE VILL7A3E PEOF="5 BLOGE W :03500 -D75El 09/24(14 4k*k***150.:70 - t,'"1"*.k. VOL E,1.0i5 SE1104t4 GENERAL rLEcT RENTAL FEE 521000000 ,674' 75.00 PEOS2E14 PR:MARY ELECT RENTAL FEE PU 213/ 1KoiroctuoIA •O* OF CLERK SUPERVISOR'S Maricopa County MARICOPA COUNT Y Human Resources Department 2015 MAR 1 2 PH 1: 5 1 Payroll & Employee Records Division 301 West Jefferson Street Suite 220 Phoenix, AZ 85003-2143 Phone: 602-506-3519 Memo Payroll Fax: 602-372-0277 Records Fax: 602-506-5509 wyr,v.maricopa.gov To: Fran McCarroll, Clerk of the Board From: Wanda Childers Date: March 12, 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 Wanda at x 6-0409 for any questions. Please route approved Affidavits back to County Payroll, Suite 220. Thank you. AFFIDAVIT/NOTICE OF CLAIM %1111'11-4-3 0 V E 15 MAR 1 1 AN 10: I." STATE OF ARIZONA MARI 3 2015 HUMAN RESOURCES COUNTY OF MARICOPA CLERK Ei0A:'iD IVIt.I01A- MA;RICOA COUNTY DANIELLE FIERROS-SANCHEZ BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the 4TH day of NOVEMBER , 20 14 , he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of NOVEMBER , said claim being in the sum of ONE HUNDRED Dollars ($ 100.00 ) in payment of which the Board of Supervisors caused the Warrant No. 22239550 to be issued on DECEMBER 3 , 20 14 , 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. 22239550 In the sum of $ 100.00 Dated: Likri 4'"-- , 20 1 G. Signe / Affi ant ***A $12.00 fee for the stop payment and reissuance of the warrant will be deducted from the replacement check.*** Subscribed and sworn to before me thiiCIL ' day ofi hIjaytd , , 20 lc-- My commission expires: 05 co, UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: 01/31/2013 11111111111- Fierros-Sanchez Danielle J - MCVELE ( Paycheck View 'v MCY-Earnings Taxes v Deductions v Garnishments Special Accumulators v Distributions Name Fierros-Sanchez,Danielle J Confirmed Check Checkt Issue Date Earnings Taxes Deductions Net Pay 22239550 12/03/2014 100.00 100.00 • Regular and Overtime Earnings - - - Taxes - Reg Hours Reg Pa} OT Hours OT Pay OtherEarnings • Deductions Code Hours Amounts Add to Gross EPW 1.00 100.00 Y Enterprise screen print as of: Mar 12 11:54 Maricopa County Human Resources Memo To: Fran McCarroll, Clerk of the Board From: Lisa Platek Date: March 12, 2015 Re: Replacement of Lost Payroll Warrants Please find attached 1 Affidavit/Notice of Claim(s) for lost payroll warrants for inclusion on the next available Board agenda. The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re- issued. The original warrant(s) have had a stop payment done. Please call Lisa at ext. 63619 for any questions. Please route approved Affidavits - back to County Payroll, Suite 220. Stale Dated Warrant Duplicate Warrant Thank you. RECEIVED MAR 1 3 2015 MAR1COPA COUNTY CLERK BOARD OF SUPERVISORS APRROVED MAR 13 2015 AFFIDAVIT/NOTICE OF CLAIM CLERK BOARD OF SUPERVISORS MARICOPA COUNTY 15 MAR 12 07 STATE OF ARIZONA HUHAH RESOURCES COUNTY OF MARICOPA D Pcfp BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the day of N.A_(vf-c I-\ , 20 1 CS , he/she presented ' to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of k•-A-1-\ 2 LA-4 , said claim being in the sum of t•-) k ou t•-)(-) \ 1-k to ki..10 0 L-LfI P, N -TwE--v-Yr---1 c_e v•-5-rs vw-ze . Dollars ($ . ) in payment of which the Board of Supervisors caused the Warrant No. to be issued on NAINe_c_kA , 20 k e5 , 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. "DD to-1 In the sum of $ 1 Dated: tA_Nack-A , 20 \ Signed: /Affiant ***A $12.00 fee for the stop payment and reissuance of the warrant will be deducted from the replacement check.*** ..- PORTIAigsiaii#Xn sworn to before me this 2- day of PACk-4-1,—, 20 IS' Nottpluble State ofklzono 100PA COUNTY My Commieslon Expires) Juno 16,2017 Notafy Public My commission expires: UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: U1 / 1 /LU I