STAMPED & REDCATED - JUSTIN ANDREW HUGHES.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: 01/14/2025

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

Litchfield Dist #79 Hughes, Justin Andrew 3700833246 | $1,108.18

Office of the Maricopa County

School Superintendent

District Name / Number: \¢S py]

Contact Name: C cork
Contact e-mail:

Warrant Void/Stop Request

Attachments:
[| Original Werrant
[| infinite Visions Void Report
Xf Lost Warrant Affidavit (if requesting reissue)

[| Vendor Letier (if requesting reissue for a company)

Warrant Number Warrant Date Amount
{starting with “37") (ram/de/yyyy)

Payee
fas It eppears in Check Manager)

TATVWLLS % | 2 \31 12095 *|1005.19

TAO F770

Huaglaec, Justin Andrew

Check here if requesting MCSS reissue the warrant: Me

Notes:

vee ANOS

District Approver: Naveen Wa ott

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.

¢ (1), being first sworn, upon oath deposes and says:

On or about V0 (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 recelved 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 clalm 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 $ si\ | Ns1% (3)

Signed: (4)

(5) Subscribettard sworn to before me this__/() _ day of _w pc 20.25.

NOTARY PUBLIC
BRITTANY CARTER
M . Notary Public + Arizona
f ires: faricopa County
y 6 mmission expires cy Commission # 655274
Oune 1%, Got Y My Comm, Expires Jun. 18, 2027 (seal)
? ee

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

werent | 1A 215 » [sanoarg24 0 Hh

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

© For Services or Goods furnishe”
O Other:

1/14/25

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\
Revised June 2015 32 & 15-999

1NAI25, 10:15 AM

VMware Horizon

os i7i iy
Z ae) |
1 elt Warrant | Status | Print | Attachments
Maintain New Status | Setup | Attachments
3700833246
“4 Warrant header
General Posting
Warrant number: 3700833240 Invoice:
Holder: Invoice date:
Issued date: 12/31/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent cate: 12/26/2024 09:00:18 am
Exception flag: | Agency details
Exception reason: None

Queued for positive pay: |.//

Agency low orig:

Locked forreconcile: [| 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
oO Amount i Payee i Account

1,108.18 Hughes, Justin Andrew

Agency voucher number: 14
Agency clair number:

lq <f b bl | o | 19) | Identification of the warrant

https://horizon.maricopa.gov/portal/webclient/#/desktop

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