STAMPED & REDACTED-HAIDEE RUIZ -3700874420.PDF

V
MARICOPA
COUNTY

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (CHRISTY ADAMS)
SUBJECT: AFFIDAVITS —-REPLACEMENT OF LOST WARRANTS

DATE: 07/22/2025

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.zoy. 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

Balsz Elm SD #31 Haidee Ruiz 3700874420 $529.40

v . Finance Desk
MARICOPA som 20201016

Date

Amount

Reissue WT #

COUNTY
Warrant Void/Stop Request

District Name / Number: Balsz Elementary School District #31 Attachments:

Contact Name: Marisol Bernal Martinez | Original Warrant

Contact rT s—SsSCSY | Lost Warrant Affidavit (required for ALL reissues)

[ ] Vendor Letter {if requesting Vendor reissue}

Warrant Number Warrant Date | Amount Payee
(starting with “37") (mm/dd/yy) (as it appears in Check Manager)

Void
Stop

3700874420) 5/26/2025|$ 529.40 Haidee Ruiz

Notes: Check was lost.

District prprowe pan nS ec Date: Cc Qe Ss

For Internal Use Only ™

Clerk of Board Date: Void Report Date:

lL
Schools Affidavit/Claim Form MARI COPA
Application for a Duplicate Warrant/Check COUNTY

(definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond te numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
REN dee Qurz. (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about Moy 2, 2025 (date) (2) a warrant/check was issued to the above-named
person/entity in thé amount as stated below. Such warrant/check was either never recelved 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 i inthe sum of $. 229-0 . (3)
Signed: Ay (4)

IN . ;
Print name: (required) Has Le. feud 2

(5) Subscribed and sworn to before me this D.\0 day of uw 20.25,

KRY PUBLIC qs AMANDA CA

Notary Public - Arizona

oe . 4 No Maricopa County (
y comms on expires: ae uy Comme Boyes Jun 20, 2027 6
Une. 2O2 0771 ) ee aac, (seal)

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) 2ToorWyu7e
Original Date of Issue

(if known) (7) OS: 26-7075

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

For Services or Goods furnished

Other: Bee

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

7/22/25

Warrant (1 - meto) - Warrant number: 3700874420, Stopped

| Warrant |
Ca Se id MS
hi Warrant | Status | Print | Attachments
v
Maintain |__ New | Status | Setup | Attachments
| 3700874420
“a Warrant header
General Posting
Warrant number: 37008 74420) Invoice:
Holder: Invoice date:
Issued date: 5/26/2025 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 5/27/2025 09:31:15 am
Pectin flag: it Agency details
ception reason: None Agency voucher number: 2553
Queued for positive pays i] Agency claim number:
Agency fow orig:
Locked for reconcile: = || Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num
No of days interest: 0
Annual interest rate: 0,00000
Da Warrant Lines
[1 Amount Payee Account