DUPLICATE WARRANTS PAYROLL.PDF

AFFIDAVIT/NOTICE OF CLAIM
STATE OF ARIZONA ea. rt I B
DE OCT 1 2013
COUNTY OF MARICOPA v=4',4i
CLERK, BOAR b OF gOPSFMS
MARICOPA COUNTY
Milinda Kristina Flores —BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 1st day of October , 2013 he/she presented
to Maticopa County, for payMent a claim for services rendered or supplies furnished during the
month of August , said claim being in the sum of
Thirty Nine Dollars
Dollars ($39.00 ) in payment of which the Board of Supervisors caused the
Warrant No. 22121714 to be issued on August 28 th, 2013 , 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. 22121714 In the sum of $39.00
Dated: JS ,20 72 Signed:
Affiant
DAVID M YR1GOYE1
Notary Public - Arizona
Moricopn County
My Comm. Expires AP 26. 2017i bscribed and sworn to bAre me this / c. day of 0 ,20 ig
ze4‘.
Notary eb ic
My commission expires:
6 *-;
T A /TIM 0-NA 7 • TNT • CIT, a .• A TT 1, TT, • r,r rr't TT !IT TT
01/31!2013

AFFIDAVIT/NOTICE OF CLAIM
APPRO
STATE OF ARIZONA OCT 30 PH 3: 40
alaifpre
COUNTY OF MARICOPA
Z-,LERK, BOARD OF SUPERVISORS
MARICOPA COUNTY
triS ?0, pq re BEING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 13 day of 0(30)Cler , 20 1 he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of tkitiOer , said claim being in the sum of
.ven -h.t441 eliCt4 Ablteds 1+41 one cen#3
Dollars ($ ) in payment of which the Board of Supervisors caused the
Warrant No. p_tbkog. to be issued on oc+ci-e 3 , 20 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. L2)3(e01 .2 In the sum of $ I. 91
Dated: O ,20 16 Signed: 0. th1unQ\
A fflant
***A $12.00 fee for the stop payment and reissuance of the warrant will be deducteTfrom the
replacement check.***
Notary PATRICIA Pu . THQE KE. sworn to before me this +41 day of OaDhey- , 20 1 3
MAR1COPA COUNTY
My Commission Expires
November 14,2015 oted.442.0 a
Notary Public
My commission expires: 1V14//5
UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO:
Name:
Address:
Address: s
01/31/2013

AFFIDAVIT
FOR WARRANT#340004150 Witness Reimbursement
A IP it 02, 'V E
DATE OCT 5 2013
STATE OF ARIZONA
COUNTY OF MARICOPA RK, MARI bOARD CORA OF COUNTY SUPERVISORS
Karen Price being first sworn, upon oath deposes and says:
That on 8/13/13 presented to Maricopa County, for payment, Reimbursement for Per
Diem & Taxi Reimbursement _ In the Amount of: Two Hundred Thirty Three Dollars
and Sixty-Five Cents.
In payment of which the Board of Supervisors caused the Warrant
No. 340004150 to be issued on 8/19/13 drawn on the 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 of said Warrant No. 340004150 in the sum of $233.65
Signed:
Karen Price
Subscribed and sworn to before me this lq day of , 2013
-4,49
My commission expires: q/ --N) I 216-1 NOTARY PUBIJC
riAt 1111 ALId[ss'',,AF
1(.(1[..H.HIL14,11-1111-11 11„..li IIII""11
ALLA," IIII II1(

AFFIDAVIT/NOTICE OF CLAIM
ER k, EOARD OF SUPERVISORS
STATE OF ARIZONA IVARICOPA COUNTY
COUNTY OF MARICOPA
IL%
_5 Htgueik_, BEING FIRST DULY SWOlik •"4
OATH, DEPOSES AND SAYS: crt
That on the ii day of CDyi Ci& , 20 1 he/she pent*
to Maricopa County, for payment a claim for services rendered or supplies furnished during 416 ‘,0
month of 0610b.e.r , said claim being in the sum of
(56t/eg kt.utira 5/fly —kW eld4rs 0,4,6
Dollars ($ lt45 ) in payment of which the Board of Supervisors caused the
Warrant No. goll 3 03-7 11 to be issued on Cablur ,20 13 , 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 penalt y of
perjury, affiant hereby affirms that this claim is correct and the amount shown is due and owin g.
WHEREFORE, affiant requests that the Board of Supervisors issue to him/her a duplicate of said
Warrant No. In the sum of $
Dated: , 20 Signed: AI
Affiant
***A 512.00 fee for the stop payment and reissuance of the warrant will be deducted from the
replacement check.***
Subscribed and sworn to before me this 11 'Say of 6094,4ei-; 20 /3
uhlie KAREN k M. DICKEY
My commission expires: NOTARY PUBLIC - State olArizona
MAN1COPA COUNTY
Z—c44) I. o15 My Comm. Expires July 2011
ASE MAIL REPLACEMENT CHECK TO:
Name: Telephone Number:
Address:
Address:
4/3/2012

AFFIDAVIT/NOTICE OF CLAIM
i OCT 1 6 PM 12: 214
STATE OF ARIZONA APPROV E.
OCT 24 2013 -,. L Li
COUNTY OF MARICOPA
1ek;11A1 --ktun OtO I MARICOPA COUNTY IRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the '114 day of (t) (1,t0 b , 20 t3 , he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished durin g the
month of c.,e,w-AiAbe.{ , said claim being in the sum of
Dollars ($ I ) 033n I ) in payment of which the Board of Supervisors caused the
Warrant No. „:22- I :&„,9- 1 I-3 to be issued on ockbei q 20 13 , 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 owin g.
WHEREFORE, affiant requests that the Board of Supervisors issue to him/her a duplicate of said
Warrant No.‹..4 331 I 3 In the sum of $ 1 ) 3c), 7 3 .
Dated: ao-pbe, LID , 20.1 3 Signed: Flabe.h.,
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 day of 0 , 20 IjS
a..1.A&Int/J Pilia1C1
Notary Publi OFFICIAL SEAL
My commission expires: EILEEN WILLIAMS-PREAS
NOTARY PUBLIC - State 01 Aiii0112
11-Zi4 O 1' My Comm. MARICOPA Expires COUNTY Nov. 9,2014
UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK
Address:
01/31/2013

AFFIDAVIT/NOTICE OF CLAIM
A 12 7? 11 V 13 OCT 2 I :,4 AN a1/401s, 11: 37
STATE OF ARIZONA 6,
DAT_ T 1 2 2013
COUNTY OF MARICOPA
RK, EOARDOFSUPEFyjr .7-7 —t. •f.
kiARICCPA COUNIY
Delphia Gross ING FIRST DULY SWORN
OATH, DEPOSES AND SAYS:
That on the 1st day of October , 2013 he/she presented
to Maricopa County, for payment a claim for services rendered or supplies furnished during the
month of August , said claim being in the sum of
One thousand, One Hundred, Eight and 00/100
Dollars ($1,108.00 ) in payment of which the Board of Supervisors caused the
Warrant No. 22120048 to be issued on August 28 , 2013 , 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. 22120048
Dated: , 20 Signed:
MisaNsillM116111.11011•11Milf ERIKA K MARTINEZ r it
NOTARY Madcap PUBLIC Cou • Vehlbed and sworn to before me this day of Cettleer-, 2013,
My Commission Expires I.
December 19, 2016
My commission expires70-e& aMta,
UPON APPROVAL, PLEASE MAIL REPLACEMENT CHECK TO:
01/31/2013