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v MAR)COPA COUNTY INTEROFFICE MEMORANDUM TO: MARICOPA COUNTY CLERK OF THE BOARD FROM: MCSS FINANCE DESK (MIKE MARTINEZ) SUBJECT: AFFIDAVITS - REPLACEMENT OF LOST WARRANTS DATE: 10/17/2025 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda. The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. The original warrant(s) have had a stop payment done. If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100. Thank you District Payee Warrant # Amount Saddle Mtn Unified #90 AZCEC 3700904326 $245.00 Date: Amount: Reissue WT # MAR | COPA District #: COUNTY District Name: SMUSD #90 Contact Name: Crystal Mondragon WARRANT VOID/STOP REQUEST Warrant # 3700904326 Warrant Date 99/10/2025 Warrant Amount $ 245.00 Payee AZCEC Choose one option: O Void Warrant Warrant is in possession of the district and will be sent back to MCSS Finance Desk with the next available courier run. © Stop Warrant Warrant has been lost or destroyed and is not in possession of the district. If requesting MCSS to reissue this warrant select the Reissue Warrant box below and submit a notarized affidavit along with a vendor letter (if payee is not an individual). Reissue Warrant: Notes: Vendor never received the check. The check was probably lost in the mail. [ake & Date: 40/16/2025 Revised 10/8/2025 Schools Affidavit/Claim Form Application for a Duplicate Warrant/ Check (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNTY OF MARICOPA Instruction sheet which is page 2 of this form. AZ COUNCIL OF EXCEPTIONAL CHILDREN fi u oath de 3A Name/Claimant (1), being fi rst sworn, upon oath deposes and says: On or about Se 10. (OP 22s (date)(2) a warrant/check was issued to the above named a eay in the amount as stated below. Such warrant/check was either never received or was subsequently inadvertently lost or destroyed and there is no reasonable probability of its being found or presented for payment, or it was not presented for payment within one year after the date of issuance. Therefore, under penalty of perjury, claimant hereby affirms that this claim is correct and the amount shown is due and owing, and the applicant requests that a replacement warrant/check be issued to him/her in the sum of $245 (3) Signed? “g Matt JDDG A bw ere/ (4) (5) Subscribed and sworn to before me this__ 27 day of O2704 E72 20-8 : aaa ~ NOTARY AgBLIC Notary Public State of Arizona S Pima County My commission e Mary Lee Mathis 03/3/ [70 ; Commission Number’ 681561- (SH) Note, Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/check Number 13700904326 —_ / 10/17/25 — Original Date of Issue 9/10/2025 = > mae iz Reason for original issue of Warrant/Check (8): 0 Payroll @ For Services or Goods furnished AZ CASE Survivors Conference O Other: AZCASE Survivors Conference S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 a Council for Exceptional | ARIZONA Children October 7, 2025 Saddle Mountain School District Crystal Mondragon, Accounts Payable Dear Crystal, Regarding our recent communication, the check sent to Arizona CEC on or about Sept 10, 2025 has not been received. The check was for payment for Saddle Mountain staff to attend the Survivors Conference in August 2025 and was in the amount of $245. I am requesting that this check be re-issued to Arizona CEC and sent to our mailing address: Arizona CEC 1am affirming that I am the duly elected Treasurer of the Arizona Council for Exceptional Children. Sincerely, —s a ee me geet cele» Petra Schmid-Riggins Treasurer, AZCEC Warrant (1 - mcto) - Warrant number: 3700904326, Stopped Warrant Warrant Status Print Attachments ad Maintain New Status Setup Attachments 3700904326 4 Warrant header Warrant number: 3 04326 Invoice: Holder: Invoice date: Issued date: 9/10/2025 12:00:00 am Paid date: Status: Stopped Positive pay sent date: 9/11/2025 09:30:44 am colon flag: t son: ESE eS _ mene Agency voucher number: 2611 Queued for positive pay: Agency claim number: : Agency low orig: Locked for reconcile: Agency PO number: Registered Agency sub fund: Date registered: Agency dept num: No of days interest: 0 Annual interest rate: 0.00000 4 Warrant Lines oO Amount Payee Account Iq <4 m PL | 7 | ® | Identification of the warrant