REDACTED-FOR AGENDA ATTACHMENT-GREAT AMERICAN TITLE AGENCY INC.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 je
maria.quitangon@maricopa.gov
602-506-1958

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

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No
GREAT AMERICAN TITLE AGENCY 957792 $594.71 | Treasurer

INC

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form

This application is for: [] Duplicate or [fl Stale-Dated (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.

Great American Title Agency, Inc. (4), being first sworn, upon oath deposes and says:

Name/Claimant

On or about May 23, 2023 (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 wie sum of $. 594.71 .(3)
Signed: £ (4)

Print name: (required) Bruce Beverly, Chief Executive Officer

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

(5) Subscribed oar me this /Y__day of Hhyuary 2025.
C

NOTARY PUBLIC. 7”

My commissign expires:

“LO? !

e

JANET R. NAVARRETTE MOE
Notary Public - Stale of Arizona i
MARICOPA COUNTY
Commission # 631474

i Expires August 07, 2026

(seal)

Warrant/Check Number 957792 -

(if known) (6)

Original Date of Issue
9 (if known) (7) May 23, 2023

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

O For Services or Goods furnished.
Treasurer's refund/payment Refund of 2022 Overpaid Real Estate Taxes

O Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 ARS. 11-632 & 11-644
VErerrey
2/r0f 2s

[t-

Great American

TITLE AGENCY, INC.

Bruce E. Beverly
Chief Executive Officer

February 19, 2025

Maria F. Quitangon

Maricopa County Treasurer’s Office
301 West Jefferson St., Suite # 100
Phoenix, AZ 85003

Re: Request for Replacement Check
Original Check # 957792 dated 5/23/23 for $594.71

Dear Ms. Quitangon;

| Attached please find a completed s, signed and notarized Application for a Duplicate or State-
Dated Warrant/Check form.

Pursuant to your recent conversation with Ms, Gorman of this office, the above referenced
check was not received or cashed so we respectfully request that it be reissued.

This letter will certify that I am authorized, as the Chief Executive Officer of Great American
Title Agency, Inc., to sign the attached claim form.

Should you have any further questions about the attached, please do not hesitate to contact ,e/

Sinferely,

é

ruce % Bevofly
Chief Execyfive Officer

Attachment

Maricopa County Treasurer's Office 207-34-077 6 2/20/2025 8:05:26 AM

FBR 207-34-077 6 = x
File Help
Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act Time
42024 = TAX PAYMENT 2024-11-01. =MO -F454 $628.57 N 2024-10-31 1 7:21:00 Ph |
1 | 2024 INFO STATEMENT 2024-08-25 N 12:00:00 4
| 2024 TAX BILL 2024-08-24 Y 12:00:00 4
12023) TAs PAYMENT 2024-04-30 MO -F454 $616.44 N 2024-04-30 F 9:22:00 Ph
2023 TAX PAYMENT 2023-10-27 =MO -F454 $616.44 N 2023-10-27 1 7:47:00 Ph
2023 = INFO STATEMENT 2023-08-26 N 12:00:00 4
2023 TAX BILL 2023-08-26 ¥ 12:00:00 4
2022 CT IMPOUND 2023-04-26 054-37566 $594.71 6:31:00 Pb
Parcel #: (207-34-077 Activity: REFUND Act Date 05/24/23
Tax Year: [2022 Tran #:["- fa Act Time {12:00 AM

Activity Detail | Address Detail |

cP# Check Date: [05/24723
Buyer#: [OCS Check #: [957792
Fund 26 °° Refund Amount: | $594.71

Click icon for Disbursements Inquiry. ----->

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Maricopa County Treasurer's Office

8:06:31 AM

| BS Refund ID 2023008900 MANUAL

ee Oo

x
File Help
SL)
Refund Amount: fs594.71 Requester, |RAMONA.MORAN on 5/22/2023

| Refund Reason: [Overpayment of property taxes

Status: [DISBURSED on 5/22/2023
Slip ID: |202300239

Address:

Impounds | Stub | Comments |

LINC.

Check Request: [MAIL

Reference #: |

Source Fund | Linked |

Amount | Tax Year | Status

064 True

$594.71

2022

READ

Impound Total : 1

Impound #1
Parcel/Roll :|207-34-077 Dest fund : [026
cp#: fo Reso: [0
CP buyer # 10 Phase #: [0
Mottgagecode: [
Transaction #: [05437566
Case #: [

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2/20/2025