REDACTED-FOR AGENDA ATTACHMENT-LINDA ALFARO-#977406.PDF

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

l
M A R) C Oo PA Cc oO U N TY atte: Phone: (602) 506-8511

rer.maricopa.gov
TREASURER’S OFFICE

mee: oer ce a ae men a a a

To: Clerk of the Board
clerk.agenda@maricopa.gov

Dorene.Stretar@Maricopa.Gov

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

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

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No

LINDA ALFARO 977406 $162.71 | Treasurer

M A hee Cc ° PA Application for: a Duplicate c or Stale Dated
COUNT ¥ ant/Check affidavit/ciaim Form::

This application i is for_ J Duplicate or
STATE OF ARIZONA. , Note: inbers t on. n this form. correspond to.the numb:
COUNTY OF MARICOPA on the Instruction sheet which is page 2 of this forin
Linon S.ALEARO (1), being first swron, upon oath deposes and says:
Name/Cigimant aaf LA
On or about _#@- gear (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. CAcee 7 977+406'

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 $_£6 2. wal . a. (3).

Signed: ma : a Ch kyoss (4):
Print Name: ‘eedared) Zeer wpa! 4 L EKL-O -

- Note: Please attach a copy of the warrant/check if available and/or any other evidence that 2:
warrant/check, was originally i issues.

(5) subseibsjand sworn to bsfoy me this 2a

NOTARYSUBLIC =|

JOSE G LARA
Notary Publie - Seal
‘Porter County - State of indiana
Commission Number NPO7$3305.  -
My Commission Expires Dec 12, 2031

My cominission expires:

[z12-/ 205 |

Wantat/Ghleble Number : e ge 977 4 0 =
Original Date of Issue: =. +.
__f known) (7). 4 pe Bee ge
" Reason’ for original isstié Of Warrant/Check (8) ©
_O Payroll

For Services or Goods furnished

A Treasurer's refund/payment ___

ca

“her:

Ss APROCESSES\Warrants- Duplicate or Stale\o2 Forms\Current Claim Form\1 \100518 8 Warrants Checks notice of claim. doc i ‘Revise:
10084; yererey Wks

ARS, 11-689 BY 26

"BB 503-66-219 5

File Help
Year_| Description [ActDate | TranNum | Amount | Images _| PmtDate | Half Code | Act
2023. REFUND 2024-04-25 : $157.41 N 12:
2023. RES REFUND LETTER 2024-04-24 N 6:3
2023. RES IMPOUND 2024-04-24 AS -72362 $157.41 N 6:3
2023. TAX PAYMENT 2024-04-24 AS -72362 $990.00 N 2023-09-25 =F 6:3
2023. «=POST NEW TAX(RESOLUTION) 2024-04-24 AS -72362 $990.00 N 6:3
2023. CANCEL TAX 2024-04-24 RS -72362 $1,139.46 N 6:3
2023. RESTORE TAX 2024-04-24 AS -72362 $1,139.46 N F 6:3
2023 RESOLUTION REPRINT 202: Y 12:
2022. REFUND h 2:

Parcel #: |503-66-219 Activity: REFUND Act Date|01/31/24
Tax Year: [2022 Tran #:["- [] Act Time12:004M
Activity Detail | Address Detail |
CP #: [9 Check Date: [01/31/24
Buyer #: [0 Check #: [977406
Fund: [26 Refund Amount: $162.71
-
BS Refur oO
File Help

ai
| RefundAmount: {$162.71

Requester, [RESOLUTIONS on 1/30/2024
Refund Reason: [Resolution has reduced taxes Status: [DISBURSED on 1/30/2024
Slip 1D: [202400147
Address: Check Request: [NOPC GROUP
Reference #: [RES # 72004
Impounds | Stub | Comments |
Impound #1
Source Fund | Linked | Amount | Tax Year_| Status Parcel/Roll:/503-66-219 Dest fund : 026
033 True $162.71 2022 READ) CPt: fo Reso: [72004
CP buyer #:|0 Phase #: [211
Mortgagecode: [
Transaction #: [RS 72004
Impound Total : 1 Case #: |