REDACTED - FOR AGENDA ATTACHMENT - RICARDO AND ARMIDA GUTIERREZ #1058256.PDF

V
MARICOPA COUNTY

TREASURER’S OFFICE

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003
Phone: (602) 506-8511
: r.mari gov

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov
From: Treasurer's Office
Katelyn Hale Ke
katelyn.hale@maricopa.gov
602-506-3357
Cathy Sanchez ~ C
cathy.sanchez@maricopa.gov
602-506-7881
Re: Stale Dated Warrant
Name Warrant Amount | Dept/School
No
GUTIERREZ RICARDO S/ARMIDA C 1058256 $205.30 | Treasurer

L
MA R) COPA Application for a Duplicate or Stale Dated

COUNTY Warrant/Check Affidavit/Claim Form
This application is for Duplicate or \JStale-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

Lcatho Agena G a 2LI/ELRREZ (1), being first swron, upon oath deposes and says:
ame/Claimant

On or about 4uG.12, 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 $_2 0 47.7 0 _. (3)

Signed “ be ceed 2: Lithia (4)
Print Name: (required)__ “7 C2208 S.CWZVEARREZ

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 6 day of SePlember 2025.

ray
NOTARY PUBLIC [4a Ul y

2) CRISTINA CRUZ
oN Notary Public - Arizona
issi i i Maricopa County
My commission expires: Commission # 642793
Dy b

PIS/[2e27 SEE comm. gh

Warrant/Check Number .
(if known) (6) LOSE BZSb6

Original Date of Issue
(if known) (7) f7U6./2, 2Zo2y

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

OO For Services or Goods furnished

i Treasurer's refund/payment
a Other: Zax Casé Ve, TX 20/6 - 000 882 (Gasym yar vs Mpkile Cry)

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc Revised
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Vesieeg an3lF

BB 510-01-227 6 - x
File Help
Year_| Description [ActDate | TranNum_| Amount| Images | PmtDate | Half Code | Act
2018 RES REFUND CHECK LETTER 2024-08-13 N 35.
2018 RES IMPOUND 2024-08-13 RS -24217 $522.87 N S:4€
2018 = TAX PAYMENT 2024-08-13 RS 24217 $723.72 N 2019-02-20 F 9:4¢
2018 = TAX PAYMENT 2024-08-13 RS 24217 $1.113.30 N 2018-09-25 F S:4t |
2018 POST NEW TAX (RESOLUTION) 2024-0813 RS 24217 $1,837.02 N S:4e
2018 =CANCEL TAX 2024-08-13 RS 24217 $2,226.60 N 9:4
2018 RESTORE TAX 2024-08-13 RS -24217 $1113.30 N 1 S:4f
2018 ~=RESTORE TAX 2024-08-13 RS -24217 $1,113.30 N F S:4t
2016 REFUND 2024-08-12 : $205.30 N 12
Parcel #: [510-01-227 Activity: [REFUND Act Date08/12/24
Tex Year: [2016 Tran#[- [| Act Time {i200 4M
Activity Detail | Addess Detail |
CP #: fo Check Date: [08/12/24
Buyer #: {0 Check #: [1058256
rs Refund Amount: [— $205.30
& Refund ID 2024097671 RESOLUTION = Oo x

File Help

32)

Refund Amount [$205.30

Requester, [RESOLUTIONS on 8/6/2024

Refund Reason: [Resolution has reduced taxes

Status: |DISBURSED on 8/6/2024
Slip 1D: [202400737

Address: [GUTIERREZ RICARDO S/ARMIDA C

Check Request: |GASIMYAR GROUP
Reference #t: [RES # 24434

Impounds | Stub | Comments |

Amount | Tax Year _| Status
$205.30 2016 READ

Source Fund | Linked |
033 True

Impound Total : 1

Impound #1
ParceVRioll:|510-01-227 Dest fund :|028
ce#: [0 Reso#: 24434
CP buyer tt :|0 Phase tt: |8000
Mottgagecode: [
Transaction #: [08402057
Case t: [t—S