STAMPED & REDACTED - NORMA CORIA.PDF

Maricopa County — Formal (2025-09-12)

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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: 09/29/2025

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

Litchfield Elementary #79 | Coria, Norma 3700880376 $278.20

Date

Amount

Reissue WT #

v
MAR)COPA

COUNTY

District Name / Number: Litchfield Elementary School District #79

Contact Name: Brittany Carter

Contact e-mail:

Finance Desk
mm 20201016

Warrant Void/Stop Request

v

Attachments:

Original Warrant
Lost Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee x 2 0
{starting with “37") (mm/dd/yyyy) {as it appears in Check Manager) te & 3

&
3700880376) 6/17/2025 | $ 278.20 Coria, Norma ©Ov

©O

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Notes: | gst in Mail

District Approver: Laity (lo.

Date: 9/96/2025

For Internal Use Only

Clerk of Board Date:

Void Report Date:

l
Schools Affidavit/Claim Form MARICOPA

Application for a Duplicate Warrant/Check COUNTY

(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.

Norma Coria (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 96/17/2025 (date) (2) a warrant/check was issued to the above-named

person/entity 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 $278.20 . (3)
Signed: Land it) (4)

Print name: (required) Norma Coria

(5) Subscribed and sworn to before me this AS day of Depledt 2025.

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NOTARY PUBLIC

BRITTANY CARTER

Notary Public - Anzona
Maricopa County

AS) Commission # 655274

” My Comm. Expires Jun. 18, 2097,

My commission expires:
Sune. 1% 909-7

al)

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
(if known) (6) 3700880376

Original Date of Issue
ane (if known) (7) 06/17/2025

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

0 For Services or Goods furnished
fj Other: Travel Claim

S:\FinanceDesk\Schools-Warrants Checks notice of claim.docx
Revised May 2025 AR.S, 11-632 & 15-999

Warrant (1 - mcto) - Warrant number: 3700880376, Stopped, Status: Stopped

ric

J fl 3a) 9

Warrant Status Print Attachments

3700880376
4 Warrant header
General Posting
Warrant number: 3 6 Invoice:
Holder: Invoice date:
Issued date: 6/17/2025 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 6/18/2025 09:31:12 am
Excenti
colonel Keseniy deta
ception snail None 5 ae ee
Queued for positive pay: “ Agency claim number:
Agency low orig:
Locked for reconcile: Agency PO number:
Registered Agency sub fund: y
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000
4 Warrant Lines
oO Amount Payee Account

278.20 CORIA, NORMA

lq <4 > DI | 7 | & | Identification of the warrant