STALE DATED WARRANTS PAYROLL.PDF

NOTICE OF CLAIM
STATE OF ARIZONA
COUNTY OF MARICOPA
Richard J. Kessler & Andrea J. Smith-, being first sworn, upon oath deposes and
says:
That on the 12th day of June. 2012, they presented to Maricopa County, for payment, a
daim for services rendered or supplies furnished during the month of June 2012, said
claim being in the sum of Qne hundred thirty two and 50/100 dollars, (1132.50) in
payment of which the Maricopa County Board Supervisors caused the Warrant Number
769419 to be issued on 06112/2012, drawn on the County's Expense Fund.
Affidavit 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 requests that the Board of Supervisors issue to him/her a
duplicate ofiii Warrant Number 7694 9 in the sumilof $1.32.50.
CV% A.
Signed: illk.lasi.4 hit4L.
• efore me this day of t).-At 7 /20 1 Y
NOTARY PUBUC
My commission expires: 7 MARK HALEY
holm MARCO Public. PA Stater:IA[1=a COUNTY
MY November Commission 2, 2017 Expires
WsidatalFinanceMAP PAY1FORMS107 Affidavit Form Blank.doc
Revised March 2007 ms
12/30/2013 11:38:12 AM

NOTICE OF CLAIM
STATE OF ARIZONA
COUNTY OF MARICOPA
Jaime Rivas, being first sworn, upon oath deposes and says:
That on the 17th day of August, 2012 , they presented to Maricopa County, for
payment, a claim for services rendered or supplies furnished during the month of
August 2012 , said claim being in the sum of Four hundred eighty nine and 20/100
dollars, ($489.20) in payment of which the Maricopa County Board Supervisors caused
the Warrant Number 773780 to be issued on 08/17/2012, drawn on the County's
Expense Fund.
Claimant 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, claimant requests that the Board of Supervisors issue to him/her a
duplicate of said Warrant Number 773780 in the SUM of $489.20.
Signed:
Subscribed and sworn to before me this (0 day of 0ö Yt tta 0101 )4
NOTARY PUBLIC
My commission expires: 1 -01 8 - /7 NUN/ TAM L. OUSLEY Ste,efkizara
MRICOPA COUNTY
Nte Commiseton Expires
f February 29, 2017
11csldate \FinanceMAP PAY1FORMS107 Affidavit Form Blank.doq
Revised March 2007 ms
1/6/2014 10:54:08 AM

AFFIDAVIT/NOTICE OF CLAIM
STATE OF ARIZONA 20I30EC 31 PM 14: 01
COUNTY OF MARICOPA
Angela Margaret Cain BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 4th day of December , 20 13 , he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of November said claim being in the sum of ."0
One Hundred Fifteen
•
Dollars ($ 115.00 ) in payment of which the Board of Supervisors caused thf
Warrant No. _ 22045540 to be issued on December 19 , 20 12 , dra141 onitx
Payroll Clearing Account fund. r4,1 ••
Affiant further says that although he/she was informed and believes that the abov,e mentioned
warrant was regularly issued, the same has never been received, or has been lost. Under i)enalty 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. 22045540 In the sum of $ 115.00
Dated: 4,./„1 v , 20 13 Signed:
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 2.1 day of bozavilpe.r- , 20i3
Notary Public
My commission expires: 1 /11 /2.olio ItACHFL MARIE SMITH
Notar ubllc • Arizona
:opa County
UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO: my COM M expires Jan 11, 2016
01/31/2013

AFFIDAVIT/NOTICE OF CLAIM
2111ti JAti -6 PS 2: 15
STATE OF ARIZONA
COUNTY OF MARICOPA
Andrew M Gonzales BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 4th day of December ,20 13 , he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of November , said claim being in the sum of 4'ea
. 17;
One Hundred Fifteen Z
Dollars ($ 115.00 ) in payment of which the Board of Supervisors caused thtri
C) moo
Warrant No. 22046943 to be issued on December 19 , 20 12 , datvn = ar =the
c) ,,,,
rn
Payroll Clearing Account fund. Cil
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. 22045943 In the sum of $ 115.00
Dated: s,ano, , 20 15 Signed:
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 lq-frday of DeceolkWY , 2O i '3
Fri el S 4er,.__L_I-_,____ ( 5
Notary Public I AgOSib, SUN SECREST
My commission expires: 121 05] 2°11 Salm MARICOPACOUNTY Pubis - 810 Weems
My Commission Expires
Deeimnber 3.2017
UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO:

AFFIDAVIT/NOTICE OF CLAIM
STATE OF ARIZONA
2014JAN -6 AM II: 19
COUNTY OF MARICOPA
Leslie D. Boulais BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 4th day of December , 20 13 , he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of November , said claim being in the sum of
One Hundred Fifteen = C • --a .4-+
M C....
Dollars ($ 115.00 ) in payment of which the Board of Supervisors caused thez PP zo =
Warrant No. 22045483 to be issued on December 19 , 20 12 , draw 71 rn —3 on I the
C) = ....., ". ..E.
Payroll Clearing Account fund. .--.
rri "
Affiant further says that although he/she was informed and believes that the above meAnonetro-
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. 22045483 In the sum of $ 115.00
Dated: bee , , 20 /3 Signed:
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 pit oft r gelga3a0
i...mnrom. aim 3-1II•=.1
My commissior; expires: NOTARY BRANDON PUBLIC ME7:111l -1111.1INN11
Maricopa Coiltyy
My Commission lipsiss
01\ Jsnuary 22, 21111
ROVAL, PLEASE :1 MAIL REPLACEMENT CHECK TO:
01/31/2013