STAMPED & REDACTED - BRIANNA LYNN MCCORD.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: 01/10/2025

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

Osborn Dist #8 McCord, Brianna Lynn 3700833574 $2,014.32

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Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (definitions are on pago 2)

STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARIGOPA ‘a Instruction sheet which is page 2 of this form,

Brigon Mclora _«y, belng first sworn, upon oath deposes and says:
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On or about fet Bl/ z Y (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 belng 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 ts due and owing, and the applicant requests that a replacement

warrant/check-be Issued to jalm/her In the sum of $ 2014.32 (3)
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signed: SQ fc ie, (4)

(5) Subscribed and sworn to before me this _“] day of JANA 420, .

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NOTARY PUBLIC ‘

My commission expires:
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Note; Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was otiginally issued.

Warrant/Check Number . -
_ i roe {6) iL 210 b&33S 1 |

Original Date of Issue
(if known) (7) 14 2\ lo02-4
Reason for original issue of Warrant/Check (8):
“BA Payroll
( For Services or Goods furnished
O Other:

1/10/25
S:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\s a
Revised June 2015 S, 11-632 & 15-999

1/10/25, 9:49 AM VMware Horizon
Warrant (1 - mcto) - Warrant number: 3700833574, Stopped
ile s | Warrant |

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Lalit Warrant } Status | Print | Attachments i
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Maintain New Status | Setup | Attachments -
3700833574 j

a Warrant header

General Pasting
Warrant number: lavoice:
Holder: Invoice date:
Issued date: 12/31/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 12/30/2024 09:00:31 am
Exception flag: U] Agency detaits
Exception reason: None Agency voucher number 16
Queued for positive pay: {1 Agency claim number:
Agency low arig:
Locked for reconcile: 4 Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num: H
No of days interest: 0
Annual interest cate: 0.00000
4 Warrant Lines
oO Amount | Payee | Account

iq 4s eB A | ae | Pe | Identification of the warrant

hitps://horizon.maricopa.gev/pertal/webelienV##/desklop an

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