STAMPED & REDACTED - KENDALL KAMP.PDF
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v MAR) COPA COUNTY Office of Budget & Finance To: Clerk of the Board 301 W. Jefferson St, 9*Floor From: Office of Budget & Finance, Accounts Payable Phoenix, Arizona 85003 Date: 1-31-2025 Subject: Affidavit — Replacement of Lost Warrant P: 602-506-3561 F: 602-506-4451 Please find attached one Affidavit for a lost warrant to be included on the next Maricopa.gov available Board Agenda. * The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. e The original warrant is presumed lost. Please call Walter Chang at 506-8747 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor. Thank you. Re: Fund: 219 / D190 - County Attorney / vendor name : Kendall Kamp Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: (sal Duplicate or (J 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. Kendall Kamp (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 6/19/24 (date}(2) a warrant/check was issued to the above named person/entity in the arnount 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 g2it 90 (3) Signed: yf as ol Lt KO —- tie TOUS (4) " rn ih / Print name: (required) (OWA i BN ip Note. AHlease attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. > (@) Subscribed-and sworn to before me this___ (2 day of _ arn 20.8. YS. hi \ nw Ne) \ A Gita a NOTARY PUBLIC OFFICIAL SEAL — CIERRA CHEEVER . Notary Public for South Carolina My commission expires: Commission Expires March 10, 2030 Wares ID est (sea!) Warrant/Check Number” (Q.99003010185392 Original Date of Issue oe § (if known) (7) 6/1 9/24 1/31/25 Reason for original issue of Warrant/Check (8): : 0 Payroll 0 For Services or Goods furnished Oi Treasurer's refund/payment Other: Victim Compensation: 2016759-1 Rast 6 & Rast 7 S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\1005i8 Warrants Checks notice of claim.doc Revised 100518 A.R.S, 11-632 & 11-644 counTy expense warrant TREASURER OF MARICOPA COUNTY — WARRANT NUMBER PHOENIX, ARIZONA 3010185392 DATE " 91-2221 Two Hundred Seventy One And 50/100 Dollars $271.50 PAY TO THE ORDER OF AMOUNT Void After 365 Days NOT NEGOTIABLE For Questions - 602-506-1379 or email AP@MAIL.MARICOPA.GOV MARICOPA COUNTY DEPARTMENT OF FINANCE RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT YOUR RECORDS VICTIM WITNESS 3010185392 06/19/2024 $271.50 INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT 00000070532K 2016759-1-rqst6 — GAXIF D190 240000028583 60.00/CA 240000028583 00000070532K 2016759-1-rqst7 GAXIF D190 240000028583 211.50/CA 240000028583