STAMPED & REDACTED - CODY M BRO.PDF
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MARICOPA COUNTY Office of Budget & Finance 301 W, Jefferson St., 9 Floor Phoenix, Arizona 85003 P: 602-506-3561 F: 602-506-4451 Maricopa.gov To: Clerk of the Board From: — Office of Budget & Finance, Accounts Payable Date: 10.17.25 : Subject: Affidavit — CODY M. BRO Please find attached one Affidavit for a Duplicate Dated warrant to be included on the next available Board Agenda. * The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. e The original warrant is presumed lost. Please cali Marcia Anderson at 506-7291 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor. Thank you. Re: D240-JUSTICE COURTS-FUND 100-GAX1D 26*585-WHITE TANK JUSTICE COURT MA a) COPA. Application tor aDuplicate or Stale Dated COUNTY Warrant/Check Affidavit/Cclaim Form This application is for _ [¥) Duplicate or _[_]stole-Dated (detintions ae on page 2) STATE GF ARIZONA ~ ‘Titote: Numbers on this form correspond to the numbers COUNTY OF MARICOPA on the tnatruction sheet which is paye 2.af this form , CODY M, BRO _ : (1), being firs1 sworn, upon oath deposes and says: On or about 18JUt-2025 _-_ (date) (2) a warrant/check was issued to the above named person/entity in the amount stated below. Such warrant/check was either never received or | was subsequently inadvertently Jost 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. 7 Therefore, under penalty of perjury, claimant hereby affirms that this claim is correct and the “amount shown is due and owing, and the applicantrequests that a replacement warrant/check be issues to him/her in the sum of $ 195.38 S Q) Note: Please attach a copy of the warran/check if evolable and/or any other evidence thata warrant/check was originally issued. (5) Subseri shoe i) paints bere ne pe Bia Oar 0k ; wnat tiny, ih Pao : : My commission expires: mh atte 06/is/dod6 ‘ Warrani/peck Number 3010217521 _| Original Date of issue /18-JULY-2025 (if known) (7) "Reason for original issue of Warrant/Check ®): -D Payroll : : : DB. For Senices 0: Good Rueighed COUNTY EXPENSE WARRANT RAC is On (i Out One Hundred Ninety Five And 38/100 Dollars PAY ert TO THE ORDER OF -_ M.Bro For Questions - 612-506-1379 or emiil AP@MALL MARICOPA.GOV MARICOPA COUNTY DE RETAIN THIS FOR | pay YOUR RECORDS PARTMENT OF FINANCE TREASURER OF MARICOPA COUNTY PHOENIX, ARIZONA DATE OF-1R-2025 Voie After 365 Days WARRANT NUMBER 3010217521 94-2/9221 $195.38 AMOUNT WARRANT NO. WARRANT DATE NOT NEGOTIABLE WARRANT AMO MREFUND 3010217521 O7F/18/2025 SI9S.38 INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO, | VOUCHER NO. AMOUNT C72024 067243 White Tank Justice Court GAX1D D240 260000000585 195.38 260000000585 Amount [] Agency Status Marrant number — Issued date Paid date + Issued 10217521 + | . « (2000 Issued 3010217521 Tigfenes 498.38) Warrant numtber: 30702 Account Amaunt Payee Cody M. 16 Ero