Extracted text (via pymupdf_layout)
2984 characters
AFFIDAVIT/NOTICE OF CLAIM 14 SEP 29 Ail 10: 23 STATE OF ARIZONA HU; 1E,30URCE3 COUNTY OF MARICOPA -TA PLO 1/0 kekt-r-) BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the day of 50.)044,4ka_r , 201 , he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of , said claim being in the sum of ( f".• -.. ck .e, 5e150.4Cfrt.0 t 1 t e€10 1 rt-ixevot4 e,ot 9- thl jAy -,9,0 4e it-4-A /06. Dollars ($ i. ) , 11-3- ) in payment of which the Board of Supervisors caused the Warrant No. 9.A. c 3L to be issued on , 20 ) , 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. a /6)3 2 In the sum of $ Dated: (-7 ,20 /L/ Signed Atari ant ***A $12.00 fee for the stop payment and reissOnce of the warrant will be deducted from the replacement check.*** Subscribed and sworn to before me this --2L ( day of c)p-i0o4w:, 20 / DENA L BARRON Notary Public - State of Arizona MARICOPA COUNTY My exyiiikeimon expires -Fairuary 2, 2017 UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: Name: _ Telephone Number: Address: Address: 4/3/2012 APPROVED DATE SEP 0 2014 AFFIDAVIT/NOTICE OF CLAIM MAAICOPA COUNTN; 14 ,..;( 2 STATE OF ARIZONA COUNTY OF MARICOPA HUNAN REAURCES 617 Cti Cn a nclar BEING FIRST DULY SWORN OATH, DEPOSES AND SAYS: That on the 3DTh day of S‘QiykQxn_bw& . , 20 T-k , he/she presented to Maricopa County, for payment a claim for services rendered or supplies furnished during the month of &_p_Acrt,exyvber , said claim being in the sum of Dollars ($.__04_1__) in payment of which the Board of Supervisors caused the Warrant No.oWAILT90 be issued on 2014 , 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 peijury, 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 Nodiada11133 In the sum of $ Dated: °\ "- ;0 , 20 VA Sigmed: ot.A.A4."03 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 30 day of , 20 ILI") 1\100FteguISIE6AL My commission expires: k . . EILEEN WILLIAMS-PREAS '1 NOTARY PUBLIC - State of Arizona My Gomm, MAR ICOPA Ex p o§ COUNTY NOv, NOV 9, 014 UPON APPROVAL, PLEASE MAIL NT CHECK TO: Name: N4- (Aik.y(VA I•J\ Telephone Numbe Address: Employee ID #: Address: 01/31/2013