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INTEROFFICE MEMORANDUM Ilaricopa County Education Service Agency (aka Ilaricopa County Superintendent of Schoorr Office) TO: CLERK OF WE OOARD FROM: Willie Thompson SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 3/4/2015 (Please find attached 2 Affidavitrnatice of Claim(s)for lost -warrants for inclusion on the nek-t 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 Wale clilompson at 506.3898 or via e-mail at miffie,thompson@mcesa.maricopa. gov. Approved Affidavits ma y be routed back to the Superintendent of School finance Division at 4041 X. Central . _Avenue #1200, (12° Eroor) Thankyou, # 5 ISAAC ELEW RETWALDO DigVIAS $662.78 #214 'TOLLESON - 'MON - 94101AEL WILE( $160.33 RECEIVED MAR 0 6 2015 CLERK 130A,RD PlCopA SUPERVISORS coliNTY APPROVED pAT -A 1-AR 10 2015 AFFIDAVIT K - EiC)AHD Or SUPI- , riVI01-TS MARICOPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA rnicbA-c,t F Wiley , being first duly sworn, upon oath deposes and says: That on the2kty la of 1-1-6-1=)- 20 i , he presented to 'r 1A Nat) District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of alnlAr,-A-1 20iC , said claim being in the sum of Ave_ 4-luincl.rei all '0 Dollars, ($ J1033 ) in payment of which the Superintendent of Schools caused his/her Warrant Number 1 5-CD Li -1S- 13 to be issued on,...goitAN g , 20 IS- , drawn on the (/) 1 Fund of 75116ot )rm.ot, A sh &Iva 1 District of of Maricopa 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 } S-00 1-11 C 13 in the sum of Signed: Subscribed and sworn to before meAis eP 7 day o , 20/ 6 PATRICIAA. MUNOZ Notary Public- State of Admit NOT MAR1COPA COUNTY My commission expiresitipit 20 /7 Expires Sept. I, 20:1 Following approval please return this affidavit to the Maricopa County School Superintendents Office. Affidavit STATE OF ARIZONA ) COUNTY OF MARICOPA) ld ...being first duly sworn, upon oath deposes and says: That on the day of , 20.1r-he presented to the of Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of. AlAa/9., said claim being in the sum of 50( hwicired‹rt",z, 17-1/0 71-iisre/ Dollars ( SI& V7S1- in payment of which the Superintendent of Schools caused his Warrant Noire)°5(4,0to be issued on 6 /9 , 20 /ST drawn on the 30Fundof ./S54 0S-- of Maricopa County, Arizona. Affiant further says that although he 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 a duplicate of said warrant number S-000 S-Lo. the sum of (eColza. -7(11 Subscribed and sworn before me this 2-1421-14day of T'ItApgiP-4tj , 20.15 .......(notary public) RYAN OFFICIAL FRENCH SEAL my commission expires. PAime-tk r3 oIL NOTARY PUBLIC — STATE OF ARIZONA COCONINO COUNTY My commission expires March 13. 2016. Following approval please return this affidavit to Maricopa County Schools. R Maricopa County MAR 0 6 ?OH Human Resources Department MARIC0c-JA t..;UUNTY CLERK BOARD OF SUPERVISORS Payroll & Employee Records Division 301 West Jefferson Street Suite 220 Phoenix, AZ 85003-2143 Payroll Phone: 602-506-3519 Fax: 602-372-0277 Memo Records Fax: 602-506-5509 ‘vww.maricopa,gov To: Fran McCarroll, Clerk of the Board From: Wanda Childers Date: March 6, 2015 Re: Replacement of Lost Payroll Warrants Please find attached I 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. 811117617 Hernandez-Vega , Ramona Leonor MC1/ELE Paycheck View MCY-Earnings Taxes Deductions I Garnishments Special Accumulators rDistributions Name Hernandez-Vega,Ramona Leonor Confirmed Check Cheat Issue Date Earnings Taxes Deductions Net Pa) 22219885 09/24/2014 165.00 165.00 Reg ularand Overtime Earnings Taxes Reg Hours Reg Pal OT Hours OT Pa) Other Earnings Deductions Code Hours Amounts Add to Gross EBT 1.00 25.00 Y EER 10.00 Y EPS 1.00 115.00 Y ESU 1.00 5.00 Y Enterprise screen print as of: Feb 10 11:20 APPROVED MAR Lo 7015 ATE CLERK, BOARD OF SUPERVISORS AFFIDAVIT/NOTICE OF CLAIM MARICOPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA Ramona Leonor Hernandez-Vega BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the 28th day of October , 20 14 , he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of August , said claim being in the sum of One Hundred Sixty-Five Dollars ($ 165.00 ) in payment of which the Board of Supervisors caused the Warrant No. 22219885 to be issued on September 24 , 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. 22219885 In the sum of $ 165.0 Dated:o a , 20 LS Signed: GLORIA J. NICHOLS IICVARI PICIF40agri9 and r,worn to before me this k.,i5lay of ,20 is' *Commission Expiros Fob. It 1101$ Notary Public My_commission expires: rk•- 023, 020/8j UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: 01/31/2013