Extracted text (via pymupdf_layout)
1226 characters
AFFIDAVIT CLERK, BOARD OF SUPERViSORS MAR#COPA COUNTY STATE OF ARIZONA COUNTY OF MARICOPA Courtney Hava Brock, being first sworn, upon oath deposes and says: That on the 17th day of September, 2013, they presented to Maricopa County, for payment, a claim for services rendered or supplies furnished during the month of September 2013, said claim being in the sum of Thirty and 95/100 dollars, ($30.95) in payment of which the Maricopa County Board Supervisors caused the Warrant Number 340006700 to be issued on 09/17/13, drawn on the County's Expense 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. Wherefore, affiarit requests that the Board of Supervisors issue to him/her a duplicate of said Warrant Number 340006700 in the sum of $30.95. Signed: C Subscribed and sworn Co before me this day of aln,l) ii ii\li-•:--- NO1AP61 PUBLIC My commission expires: LYNETTE KOWANETZ Notary Public - Arizona Maricopa County My Comm. Expires Sep 5. 2016 Nw--aip--sir—vs.—ciep.Raimmgp=trep.azi.413mt llcsidatalFinance$1AP PAY\FORMS\07 Affidavit Form Blank.doc Revised March 2007 ms 1/28/2014 12:19:33 PM