021815 MAIN STALE DATED WARRANTS DOCUMENT.PDF

RECEIVED
Maricopa County
FEB 2 2015
Human Resources
MARICOPA COUNTY
CLERK BOARD r CUPDIVICORG
Payroll & Employee MEMO
Records Division
301 West Jefferson Street
Suite 220
Phoenix, AZ 6003-2143 Date: 01/30/2015
Phone: 602-506-3519
Payroll Fax: 602-372-0277
Records Fax: 602-506-5509 To Fran McCarroll, Clerk of the Board
www.maricopa.gov
From: Sharan Finney, Payroll Specialist
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.
This item is a Duplicate Warrant Stale-dated Warra;›
Please call Sharan Finney at 506-6329 for any questions.
Approved Affidavits may be routed back to County Payroll, suite 220.
Thank You.
Vaireut7eapteey
c c : Sharan Finney
Payroll Specialist
602.506-6329
Fax 602.372-0277

AFFIDAVIT/NOTICE OF CLAIM
STATE OF ARIZONA 15 JAN 30 AM 43
COUNTY OF MARICOPA # tr •- •"%r` 77 ,'"
hri 5+1 ne, eob BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 154- day of 00A-Dber , 20 14 , he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of 44 (4_,Ste. (DOB , said claim being in the sum of
—T-(1,30 kU,r) AMC' aid IC CIO II arS
Dollars ($ '8 Co - ) in payment of which the Board of Supervisors caused the
Warrant No. aaligigi to be issued on fl.IA.1 , 02 8 20 1 3 , 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. 07c7 C)M' l In the sum rift (Q (i2
ela
Dated: Jan. at %-9144*
Affiant
***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 ofI day of 20
Notai
My commission expires: i Ll-----,, =,;,, CARLA D. WAYMIRE
1 ‘, '4k. ,..._.:4,,, _-,.....ii / Notary MAR1COPA Public - State COUNTY of Arizona
1 9 i .-611/45 — My Commission Expires August 10. 2015
UP(*CAP. PROVAL, PLEASE MAIL REPLACEMENT CHECK 'FO: