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AFFIDAVIT STATE OF-ARIZONA- v•ctt -e_u COUNTY OF beheal-e0PA , being first duly sworn, upon oath deposes and says: That on theallAJiav of el' 20 he presented to 1 / District of Maricopa County, Arizona, for payment, a claim for services rendered or supplies furnished during the month of Ice-ft .be_k, 20 /ad said claim being in the sum of Dr .) 3 ropmi c•pir5 Dollars, ($Q1.. I ) in payment of which the Superintendent of Schools caused his/her Warrant Number g315Z,3557, 3 is' to be issued on Pe I h e4.4 , 20/A , drawn on the piit Fund of District of Maricopa County, Arizona. Affiant further says that although he/she was informed and believes that the above mentioned warrant was regularly issued, the same has never been received, or has been lost. WHEREFORE, affiant prays that the Board of Supervisors order and the Superintendent of Schools issue to him/her a duplicate of said Warrant Number 1z3Db3 5p3q in the sunn of$ Signed: Al (2ia Subscribed and sworn to bef re me this • I ) - dy U . Th )r cJj NOTARY PUBLIC My commission expires'. I -1)015 U _ Following approval please return this affidavit to the Maricopa County Slool SuperinteRdAYVCMayerS State of Indiana Notary Public Resident of Franklin County My Commission Expires 2/9/2015