STAMPED & REDACTED - STACY OSBORN.PDF

Office of the Maricopa County
School Superintendent

Steve Watson

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA)
SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 02/14/2025

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 Mtn Dist #90 Osborn, Stacy 3700841045 $1,265.00

Date

Amount

Relssue WT #

Office of the Maricopa County

School Superintendent

District Name / Number: SMUSD 90

Contact Name: Crystal Mondragon

“eres Po

Warrant Void/Stop Request

Finance Desk
mm 28201016

Attachments:

L] Original Warrant

Lost Warrant Affidavit {required for ALL reissues)
[| Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee xs 2 ¢@
(starting with “37") {mm/dd/yy} (os it appears in Check Manager) 2 2 2B

o
3700841045! 1/29/2025 | $ 1,265.00 OSBORN, STACY O©®

Oxe]m

©O0

@©OU

Notes: Checks were stolen from mailbox

District Approver: Lil lb

Date: 9/5/2025

Por Internal Use Only

Clerk of Board Date:

Void Report Date:

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (dofinitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA lastruction sheet which Is page 2 of this form.
OSBORN, STACY (1), being first sworn, upon oath deposes and says:

NamelClaimant

On or about tb9 los, (date)(2) @ 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 ar destroyed and there is
no reasonable probability of its being found or presented for payment, er 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 ¢$1 ,265 (3)
Signed: Ne eee (4)
<7 oom renee i ne ————

(5) a sworn to before ype this_]2 day of Febevay 20.25.

NOTARY PUB)

JORGE GARCIA
]OTARY PUBLIC » ARIZONA
Marlcopa County
Commission # 673439

_| NS Wy Comm, Exp. Aug. 28, 2028

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

Waal Rua 3700841048 ee

Orginal Date of Issue” 14/29/2025

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

®@ For Services or Goods furnished CONSULTING SERVICES
[] Other; CONSULTING SERVICES

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warra
Revised June 2015 2/14/, 5

216/25, 8:25 AM VMware Horizon
Warrant (1 - mcto) - Warrant number: 3700841045, Stopped

he | Warrant |. on =n
2 Rew DD) aap) 0) |

titi Warrant | Status | Print | Attachments

|
|
|
|

Y
Maintain New Status | Setup | Attachments
3700841045
4 Warrant header {
General Posting
Warrant number 3700841045 Invoice:
Holder Invoice date:
issued dates 1/29/2025 12:00;00 am Paid date;
Status: Stopped Positive pay sent date: 1/30/2025 09;00;51 am
Exception flag: | Agency details
Exception reason: None Agency voucher number; 2528
Queued for positive pay: |i Agency claim number: |
Agency low orig: |
Locked forreconciles | | Agency PO number
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0,00000
4 Warrant Lines _ :
| Amount | Payee Account

1,265.00 OSBORN, STACY

I tics pL |” |B) | Identification of the warrant

hitps:/fhorizon,maricopa.gov/portalAvebciient#/idesktop 44