STAMPED & REDACTED-WUSD STATE TAS WITHHOLDING-3700884721.PDF

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MARICOPA

INTEROFFICE MEMORANDUM
TO: MARICOPA COUNTY CLERK OF THE BOARD
FROM: MCSS FINANCE DESK (CHRISTY ADAMS)

SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 08/05/2025

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
Wickenburg USD # 009 WUSD STATE TAX 3700884721 | $1,401.40
WITHHOLDING

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent mm 202010165

Warrant Void/Stop Request

District Name / Number: WICKENBURG UNIFIED sgrgoL DIS [Anachments
Contact Neme: LISA SMITH 4 [| Original Warrant

Contact onc ee Lost Warrant Affidavit (required for ALL reissues)

L] Vendor Letter (if requesting Vendor reissue}

Warrant Number Warrant Date | Amount Payee 3s 8 ©
{starting with 37") (am/dd/yyyy) (os it appears In Check Manager} = 2 2
wn 2

;

o

3700884721 |7/10/2025|$ 1,401.40/VWUSD STATE TAX WITHHOLDIN|@ @ Ef

@©@OU0

pay ment tyeid. checks.

Notes ease Bank lost Hrese Checks, please STep

District Approver:

vote 7/22/BS” 0
oS Val

For Internal Use Only ~ \

Clerk of Board Date: Void Report Date:

Schools Affidavit/Claim Form MA R) COPA
Application for a Duplicate Warrant/Check COUNTY

(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.

WUSD State Tax Withholding (1), being first sworn, upon oath deposes and says:
Name/Clalmant

On or about 97/10/2025 (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 penaity 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 $1,401.40 (3)

Signed: Me rine UDC (4)

Print name: (required) Denine Wong

Wh Cece. sworn to before me this G Oa aay of A gust 02S

CKIOTARY PUBLIC
GMAN
, . DENS tie nizo
My commission expires: estes,

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

Warrant/Check Number
A rot) (6) 3700884721
Original Date of Issue 8/7/25
ane tinea) CA 07/10/2025 _ 8/7]

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

C1 For Services or Goods furnished
fl Other: For WUSD State Tax Withholding

S:\FinanceDesk\Schools-Warrants Checks notice of claim.docx
Revised May 2025 ARS, 11-632 & 15-999

Wickenburg Unified School District

101 Coconino St, Wickenburg, AZ
Phone: 928-668-5350
wickenburgschools.org

Aug. 5th, 2025

To Whom It May Concern,

Please reissue the following warrants, which were all issued on July 10th, 2025. These
warrants were lost by Chase Bank and were not deposited into the account they were
payable to.

Warrant: 3700884719, $3,961.49 payable to Wickenburg USD Federal W H Tax
Warrant: 3700884720, $9,546.10 payable to Wickenburg USD FICA
Warrant: 3700884721, $1,401.40 payable to WUSD State Tax Withholding

We certify the signer on the notarized affidavit, Denine Wong, is an authorized
representative of WUSD and may communicate on behalf of our company.

JAMES SCOTT

Director of Business Services
Wickenburg Unified School District

Every child has hope, every student Is a graduate, every graduate has a dream.

H Warrant (1 - mcto) ~ Warrant number 3700884721, Stopped

| Warrant |

bafit Warrant | Status | Print | Attachments
vr
Maintain New Status | Setup | Attachments
4 3700884721
“a Warrant header
General Posting
Warrant number: 3700884 721 Invoice:
Holder: Invoice date:
Issued date: 7/10/2025 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: TAO/2025 09:31:01 am
Exception flag:
f cep fen ag I | Agency details
it sont
| xeepiion rea om Nene Agency voucher number: 1001
Queued for positive pays | Agency claim number:
Agency low orig:
Locked forreconcile: | | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: a
Annual interest rate: 0.00000
4 Warrant Lines
(1 Amount Payee Account

4,401.40 WUSD STATE TAX WITHHOLDING Po