STAMPED & REDACTED-REBECCA L MEDFORD.PDF

v
MARICOPA

COUNTY

INTEROFFICE MEMORANDUM

TO:
FROM:
SUBJECT:

DATE:

MARICOPA COUNTY CLERK OF THE BOARD
MCSS FINANCE DESK (CHRISTY ADAMS)
AFFIDAVITS ~ REPLACEMENT OF LOST WARRANTS

07/30/2025

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

Saddle Mnt # 90 Rebecca L Medford 3700877000 $371.55

Office of the Maricopa Cou nty
School Superintendent Warrant Void/Stop Request

Attachments:

District Name / Number: Sadet bt onlin Unita 48D | Criginel Warrant
Contact Name: Stivah a) ciety [| Infinite Visions Void Report

Contact ni h Lost Warrant Affidavit (if requesting reissue)

[| Vendor Letter (if requesting reissue for a company}

Warrant Number Warrant Date Amount Payee
{starting with "3771 (am ‘dd fyyyy) fas it appears in Check Manager!

310071000 | viwias [Far ss | Rebecca Lb. Ualiod

Check here if requesting MCSS reissue the warrant: A

Notes: Neer Peotived aa?

District Approver: Le fn - bere L/ ZI ZS

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (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.
Relerra. Wade — 1, being first sworn, upon oath deposes and says:
me/Claimar
On or about ___vlt ows (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 ¢ 371.55 3)

Signed: (4)

(5) a ae this 29 dayof_Quly 2025.

¥ sm 4
NOTARY PUBLIC (4% ND

_ . JORGE GARCI
My commission expires: NOTARY PUBLIC rE NVONA
gunk 28, ors Gonmisionsraieg | (62a!)
Conim, Exp, A

Note; Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued,

ere ame 2100¢M000

Original woe assue u-1p-26

Reason for original issue of Warrant/Check (8):
Pr Payroll 7/31/25
0 For Services or Goods furnished, -
0 Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 ARS. 11-632 & 15-999

i Warrant (1 - mecto) - Warrant number 3700877000, Stopped

Warrant |

bali Warrant | Status | Print | Attachments
v
Maintain New Status | Setup | Attachments
_| 3700877000
4 Warrant header
General Pasting
Warrant number: 3700877000 Invoice:
Holder: lnveice date:
Issued date: 6/10/2025 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 6/5/2025 09:30:45 am
Exception flag: i] Agency details
Exception reason: None Agency voucher number: 24
Queued for positive pay: }| Agency claim number:
Agency low orig:
Locked forreconcile: {| Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annuat interest rate: 0,00000
4 Warrant Lines
[1 Amount * Payee Account