REDACTED-FOR AGENDA ATTACHMENT-FIRST AMERICAN TITLE INSURANCE-#965674.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
http://treasurer.maricopa.gov

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

From: Treasurer’s Office

Maria Quitangon Mee

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

Cathy Sanchez CA

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

Re: Stale Dated Warrant

ma aa ae a

Name

Warrant
No

Amount | Dept/School

FIRST AMERICAN TITLE INSURANCE

965674

$171.24 | Treasurer

MA RIC OPA Application for a Duplicate or Stale Dated

COUNTY Warrant/Check Affidavit/Claim Form
This application is for LJ Duplicate or 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

Rebecca L. Smith fbo First American Title insurancy1), being first swron, upon oath deposes and says:
Name/Claimant

On or about 12/6/2023 (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 $171.24 . (3)

signed:_£¢ LYECL TALL (4)

Print Name: (required) Rebecca L. Smith

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

(5) Suscribed and sworn to before me this LO day of AlevST 20. rom

y

LO

A,
NOTARY PUBLIC

DAVID ZBIEGIEN
~\ Notary Public - Maricopa County
Commission No. 610188
My Commission Expires

My commission expires:
September 14, 2025

P/14/ 400s (sap

Warrant/Check Number 965674

(if known) (6)
Original Date of Issue
an renounlen 12/6/2023
Reason for original issue of Warrant/Check (8):
O Payroll

1 For Services or Goods furnished
Treasurer's refund/payment APN 506-40-279C
QO Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc Revised
700518

AR.S. 11-632 & 11-644

First American
Title Insurance Company

January 23, 2025

To Whom it May Concern:

Please accept this letter as First American's authorization of Rebecca Smith in our National Trust
Accounting Department to file claims for and verify information regarding Dormant Funds, on behalf of
First American Title Insurance Company, its subsidiaries and affiliates.

Please remit funds payable to First American Title Insurance Company to Rebecca's attention. If you

have any questions or need further information, please call Rebecca ‘iim

Sincerely, e

a
a a

a

Matthéw Wajner
First American Title Insurance Company
SVP, Treasurer

[BE s06-40-279¢ 4 - S
File Help

i Act Date Ima Pmt Date
2 REFUND $171.24 _N 1 Al
2023. =CTXIMPOUND 2023-10-03.» 051-36231 $171.24 10 PM
2023. =TAXPAYMENT 2023-10-02 0072-23637 $171.24 N 2023-09-27 FF ‘00 PM
2023) TAX BILL 2023-08-26 Y 12:00:00 4M
2022. TAXPAYMENT 2022-09-29 0051-28902 $172.08 Y 2022-09-28 F 6:51:00 PM
2022 = TAX BILL 2022-08-20 Y 12:00:00 4M
2021. =TAXPAYMENT 2022-05-05 0072-81415 $169.48 N 2022-05-02 -F 6:37:00 PM
2021 TAXBILL 2021-08-21 Y 12:00:00 AM
2020 TAXPAYMENT 2020-09-11 050-20693 $156.28 Y 2020-09-10 FF 6:43:00 PM
Parcel #: |506-40-279C Activity: [REFUND Act Date/12/06/23
Tax Year: [2023 Tran #["- Bl Act Time {12:00 AM
Activity Detail | Addess Detail |
CP #: fo Check Date: [12/06/23
Buyer #: [0 Check #: [965674
Fund: [26 Refund Amount: $171.24
[ &. Refund ID 2023020707 MANUAL = 0
File Help
Si
Refund Amount: |$171.24 Requester, [RHINA. CANJURA on 12/5/2023
Refund Reason: [Overpayment of property taxes Status: [DISBURSED on 12/5/2023
Slip 1D: [202300574
Address: Check Request: [MAIL
Reference #: |
Impounds | Stub | Comments |
Impound #1
Source Fund | Linked | Amount | Tax Year | Status Parcel/Roll:|506-40-279C Dest fund: |026
064 True $171.24 2023 READ| cpy: [a Resot: [0

CP buyer # :|0 Phase #: |0

Mortgage code :
Transaction #:  |05136231

Impound Total : 1 Case #: