REDACTED - FOR AGENDA ATTACHMENT - NORMAN KENNETH JR. AND MAUDE VINING #1166139.PDF

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

l
MA RICOPA COUNTY _— Phone: (602) 506-8511

TREASURER’S OFFICE

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer's Office
Maria Quitangon /

maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez
cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No

KENNETH NORMAN JR/MAUDE 1166139 $351.43 | Treasurer

VINING

MA R Cc OPA Application for a Duplicate or Stale Dated

COUNTY Warrant/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

VINING KENNGH NORMAN SR Lon VE (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 08-22-2024. (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
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 issues to him/her in the sum of $_3S | »43 . (3)

Signed. 2 ES Ludo Vi tga z= (4)

Print Name: (required) i<@uweny MOemAW ViIWMWE, Fe VET UE _WA/NG

Note: Please attach a copy of the warrant/check if available and/or any other evidence that a
warrant/check was originally issues.

(5) Subscribed and sworn to before me this 187 day of _S#PIeMecZe 20 2¢.. |

Lisa JANETTE CHAVEZ

| UBLIC
TER LUISA JANETTE CHAVEZ
2) Notary Public - Arizona
’ Maricopa Coun!
j commission expires: RY, comin tas ,
AUG /0,AO2T :
Warrant/Check Number .
(if known) (6) [iGEI39
Original Date of Issue
(if known) (7) O08 -22-2024-

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

O For Services or Goods furnished

Treasurer's refund/payment __~
O Other:

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

Seals PX

ADS 11.429 8.11.6A0A

GB 216 22 202 8

xX

File Help
| Year | Deseri ion | Act Date | Tran Num | Amount | Images _| Pmt Date | Half Code
| 2021 TAX PAYMENT 2024-11-12 RS -26515 $1,091.22 N 2021-10-22 F
|} 2021 POST NEW TAX (RESOLUTION) 2024-11-12 RS -26515 $1694.00 N |
2021 CANCEL TAX 2024-11-12 RS -26515 $2,182.44 N
2021 RESTORE TAX 2024-11-12 RS -26515 $1,091.22 N 1
|] 2021 RESTORE TAX 2024-11-12 RS -26515 $1,091.22 N F
2024 = TAX PAYMENT 2024-11-01 MO F969 $804.99 N 2024-10-31 1
2024 INFU STATEMENT 2024-08-25 N
2024 = TAX BILL 2024-08-24 Y
2020 REFUND 2024-08-22 $351.43 N
Parcel #: [216-33-292 Activity: REFUND Act Date {08/22/24
|| Tax Year: [2020 Tran#:[- je] Act Time {12:00 AM
Activity Detail | Address Detail |
CPt: [0 Check Date: (08/22/24
Buyer [0 Check#: fii65133—
Fund: [26 Refund Amount: $351.43
Ss cel
BS. Refund !D 2024205977 RESOLUTION = a) x
File Help
CIEY
Refund Amount [$351.43

Requester. [RESOLUTIONS on 8/20/2024

Refund Reason: [Resolution has reduced taxes

Status: [DISBURSED on 8/20/2024

SlipID: {202400861

Addiess: NING KENNETH NORMAN JR/MAUDE

Check Request: [QASIMYAR GROUP

Reference #: |RES #08141

Impounds | Stub | Comments |

Source Fund | Linked |

Amount | Tax Year_| Status

033 True $351.43 2020

Impound T otal: 1

Impound #1
Pacel/Roll :|216-33-232 Dest fund :|026
READ CPR: Jo Resot: [8141
CP buyer #t:|0 Phase #: [4000
Mortgagecode: [|
Transaction #: [08402061
Case #: