STAMPED & REDACTED - AZCEC.PDF

Maricopa County — Formal (2025-03-12)

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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