REDACTED-FOR AGENDA ATTACHMENT-G&D GOEMANN REVOCABLE TRUST-#1075754.PDF

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MARICOPA COUNTY

TREASURER’S OFFICE

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

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

From: Treasurer's Office nH
Maria Quitangon
maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez Qs
cathy.sanchez@maricopa.gov

602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No
G&D GOEMANN REVOCABLE TRUST | 1075754 $612.79 | Treasurer

MA AY COPA Application fora 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

DIANA GOEMA NA, Gt DGremann REVERB TEN ST

(1), being first swron, upon oath deposes and says:
Name/Claimant

On or about _% ie | 24 (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 ae) requests that a replacement warrant/check
be issues to him/her inthe sumof$_¢/ 2 7 _. (3)

Signed De Cha fot mane! (4)
Print Name: (required) “DIANA _GOEMANVN

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

4 yon . _
(5) Subscribed and syom te-pefore me this 47 “day of FUGEUS rt 20 25.

NOTARY PUBLIC Antin,

My commission expires:

UWE SF BIACE

Warrant/Check Number
(if known) (6)

(015794
Original pate of ecu g id | 1 q

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

1 For Services or Goods furnished
XM Treasurer's refund/payment Parcel * 232 a4 30
O gbe = if da

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S:\PROCESSES \Warrants - Duplicate or Stale\UZ FOFMS\Current ClalM FOrM\ 1 UUS 15 WalrantS UNECKS NOUCE OF ClallM.GOC REVISE

100518 Ver cz)

ARS. 11-6328 11-644 4|ie/s

‘BB 232-24-302 0 = x

File Help
Year_| Description [ActDate | TranNum_| Amount | Images _| PmtDate | Half Code | Act
2019 TAX PAYMENT 2024-10-22 RS -37058 $813.04 N 2020-04-20 F 7-05
2019 TAX PAYMENT 2024-10-22 AS -37058 $1,502.58 N 2019-09-30 F 7-06

2019 POSTNEWTAX(RESOLUTION) 2024-10-22 RS -37058 $2,315.62 N 705 |

2019 CANCEL TAX 2024-10-22 AS -37058 $3,005.16 N 7-06
2019 RESTORE TAX 2024-10-22 RS -37058 $1,502.58 N 1 7-08
2019 RESTORE TAX 2024-10-22 RS -37058 $1,502.58 N F 7:08
2024 TAXBILL 2024-08-24 Y 121
2018 _ REFUND 2024.08.19 - $533.63 _N 12
17 REFUND $6 N 2:

Parcel #: |232-24-302 Activity: [REFUND Act Date:08/14/24
Tax Year: [2017 Tran #:[-- Bl Act Time {12:00 4M

Activity Detail | Address Detail |

CP #: [0 Check Date: [09/14/24
Buyer #: [9 Check #: [1075754
Fund: [26 Refund Amount: $612.79
BS Refund ID 2024115292 RESOLUTION - o x
File Help
4\R
Refund Amount: [$612.79 Requester: JRESOLUTIONS on 8/8/2024
Refund Reason: [Resolution has reduced taxes Status: [DISBURSED on 8/8/2024

Slip 1D: [202400758

(eno ST Check Request: [QASIMYAR GROUP

Impounds | Stub | Comments |

Impound #1
Source Fund { Linked | Amount | Tax Year | Status Parcel/Roll:|232-24-302 Dest fund : [026
033 True $612.79 2017 READ CP H: jo Reso#: [11891
CP buyer # [0 Phase #: 7000

Mottgagecode: [
Transaction #: 108402058
Impound Total : 1 Case #:

Check Re-Issuance
1 message

Diana Goemann Tue, Aug 26, 2025 at 10:33 AM
To:
Ce:

To Maricopa County Treasurer

Hello,

| was advised by your office via phone call to contact you via email re: Parcel
#23224302.

We recently received Maricopa County Treasurer Check #1075754, dated
08/14/24 in the amount of $612.79, in our mailbox. We deposited it several
days ago. Since then, our bank has returned it as "unpaid".

Upon calling your office, your representative researched it id it was
sent to our former address

a. but was returned to you because we had moved. Your office

researched it, and recently re-sent the check to us at our current address of

Check IS Over 360 days Old, it must be re-issued after you receive this email
request from us, she said.

Would you please reissue the check and mail it to the Pp

address.

Thank you.

Diana Goemann
G&D GoemannRevocable Trust