REDACTED - FOR AGENDA ATTACHMENT - DENNIS AND JENNY DUFFY #1095954.PDF

v
MARICOPA COUNTY

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003

Phone: (602) 506-8511

http://treasurer.maricopa.gov
TREASURER’S OFFICE
To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov
From: Treasurer's Office
Katelyn Hale KAY
katelyn.hale@maricopa.gov
602-506-3357
Cathy Sanchez CID
cathy.sanchez@maricopa.gov
602-506-7881
Re: Stale Dated Warrant
Name Warrant Amount | Dept/School
No
DUFFY DENNIS P/JENNY M 1095954 $32.66 | Treasurer

MA Ay COPA Application for a Duplicate or Stale Dated
COUNTY rrant/Check Affidavit/Claim Form

This application is for Duplicate or X| stale-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to the numbers
COUNTY OF MARICOPA on the Instruction sheet which is page 2 of this form

_ DUFFY DENNIS e/ Jenny M (1), being first swron, upon oath deposes and says:

Name/Claimant

On or about Ava (6 , 2027 (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 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
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 issues to him/her in the sum of $ 32. 66 - (3)

Signed bbe we LAY, Gwyyhebhy/ (4)

Print Name: me: (required) DENSis Dorey [Genny ! Borry
Note: Please attach a copy of the warrant/check if available and/or any other evidence that a
warrant/check was originally issues.

(©) Subs cribed and nd syoryp be before me this Kd __day of 5 A

Deis.

NOTARY 1

My commission expires:
December Oi, 20rF

Warrant/Check Number

(if known) (6) [0G5954
Original Date of Issue

(if known) (7) Ave [6 2024

Reason for original issue of Warrant/Check (8):
O Payroll

O For Services or Goods furnished

ff Treasurer's refund/payment
J Other: _Seé77tre Ment

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc Revised
100518

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ARS. 11-6328 11-644 vars ng 125

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Yea | Description [ActDate | TranNum | Amount | Images [ PmtDate | HalfCode | Act
2019. TAX PAYMENT 2024-10-22 RS -28771 $572.64 N 2020-04-22 F a
2019 TAX PAYMENT 2024-10-22 RS -28771 $966.72 N 2019-10-29 F Ge
2019 POST NEW TAX(RESOLUTION) 2024-10-22 RS -28771 $1,539.36 N Ble |
2019 CANCEL TAX 2024-10-22 RS -28771 $1,933.44 N 61s
2019. RESTORE TAX 2024-10-22 RS -28771 $966.72 N 1 6:1e
2019 RESTORE TAX 2024-10-22 RS -28771 $966.72 N F 6:1e
2024 = INFO STATEMENT 2024-08-25 N 12.
2024 TAX BILL 2024-08-24 Y

12

Parcel #: [17622057 Activity: [REFUND Act Date 08/16/24
Tex Year: [2018 Tran #:[- Je] Act Time {12:00 AM

Activity Detail | Addess Detail |

ee Check Date: [08/16/24
Bye t [0 Check #: fi0gsa5¢. SS
Fund 26 22—OCOCS~™S RefundAmount: [$42.66
— a
& Refund ID 2024135616 RESOLUTION = 0 x
File Help
CIEY
RefundAmount, | $32.65 Requester: [RESOLUTIONS on 8/13/2024
RefundReason: [Resolution has reduced taxes Status: [DISBURSED on 871372024
Slip ID: [202400783
Addiess: [DUFFY DENNIS PENNY M Check Request [QASIMYAR GROUP

Reference #: |RES # 04866

Impounds | Stub | Comments |

Impound #1
Source Fund | Linked | Amount] Tax Year [Status]  ParcelRot [17622057 Dest und: [026
033 True $3266 2018 READ) cpy. [0 pesos: [#00

CPbyert#:[0 Phase: [6000
Mortgagecode: [-

Transaction # : fosa02059

Impound Total: 1 Case #: [Oo