DUPLICATE WARRANTS SCHOOLS.PDF

LITCHFIELD ELEMENTARY SCHOOL DISTRICT
272 East Sagebrush Street Litchfield Park, Arizona 85340 623.535.6000 Fax 623.935.1448 www.lesd.k12.az.us
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AFFIDAVIT LATE, SEP) 3 2014
STATE OF ARIZONA } R k, BOARD OF SUPERVisORF;
S S , MARICOPA COUNTY
COUNTY OF MARICOPA 1
A representative of W.W.Williams being first duly sworn, upon oath
deposes and says:
That on the jof July, 2014 she <he> presented to the Litchfield
Elementary School District # 79 of Maricopa County, for payment, a
claim for services rendered or supplies furnished during the month of
July, 2014, said claim being in the sum of ONE THOUSOND FIVE
HUNDRED EIGHTY EIGHT AND 00/24 Dollars ($1,588.24) in
payment of which the Superintendent of Schools caused Warrant No.
440118117 to be issued on 07/24/2014., drawn on the MAINTENANCE
AND OPERATION Fund of Litchfield Elementary School District # 79 of
Maricopa County, Arizona.
Affidavit further states that although you were informed and believes that
the above mentioned warrant was regularly issued, the same has never
been received or has been lost, stolen or destroyed and has never been
deposited.
WHEREFORE, affiant prays that the Board of Supervisors order and the
Superintendent of Schools issue to W.W. WILLIAMS a duplicate of said
Warrant No. 440118117 in the sum of $1,588.24.
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Payee Signature
$. a 0/
e?..)0 >-lubscribed and sworn to before me this /6 day of 5:24 1,-eiNkA
VS) •Z 0 14 kJ yr 'AAA,. a,
..... Notary Public
My commission expires: 00 7 dO I la
Following approval, please return this affidavit to Maricopa County
Superintendent's office.

APPROVED
DATE, OCT 2 2014
AFFIDAVIT
BO-AFTD15-FrS
STATE OF ARIZONA MARICOPA COUNTY
COUNTY OF MARICOPA
etYl.C1 c.)-rs atial if , bein g first duly sworn, upon oath deposes and sa ys:
(Name and Title of Penon)
That on Seef6449,2r , 2011-I ,he/she presented to E/ J> D I'5 of
(School District Nar4e)
Maricopa County, Arizona, for pa yment, a claim for services rendered or supplies furnished durin g the
month of Atlust- , 20 f , said claim bein g in the sum of ($ Z 2- 2 , )
PI V risk' RA Dollars in pa yment of which
the Superintendent of Schools caused his/her Warrant Number /5 O)OOic c, to be issued
on Aut, "t-b-- , 20 tut ,drawn on the 012-hicFund of rOWIC.4" Elt"enkry 50 of
(School District Namel
Maricopa County, Arizona.
Affiant further sa ys that althou gh he/she was informed and believes that the above mentioned warrant
was re gularly issued, the same has never been received, or has been lost.
WHEREFORE, affiant pra ys that the Board of Supervisors order and the Superintendent of Schools issue
to him/her a duplicate of said Warrant Number /5-0000/ck ) in the sum of $ 222 . V).
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Signed:
\ (Name and Title of Authorized Personnel
Subscribed and sworn to befo re me this 1/1 C) day of 62t P te---W-620 1
NOTARY PUBLIC/
I.V.AAIVI,AWAfuvvoeetoVvinrwWwWihfrialoW)
My commission expires: 01131 ANGEL R. SNETSINGER
NOTARY PUBLIC-MINNESOTA
My ComOssionExpiresJan.31. 2017
Following approval please return this affidavit to the Maricopa County Education Service Agency Office.