STAMPED & REDACTED- LEANN MARTINEZ.PDF

v
MARICOPA

COUNTY

INTEROFFICE MEMORANDUM

TO:
FROM:
SUBJECT:

DATE:

MARICOPA COUNTY CLERK OF THE BOARD
MCSS FINANCE DESK (ANDIE DE LA ROSA)
AFFIDAVITS ~ REPLACEMENT OF LOST WARRANTS

08/07/2025

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.

Ifyou 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 Mnt USD #90 LEANN MARTINEZ 3700800472 $98.05

Date

Amount

Relssue WT #

Office of the Maricopa County

School Superintendent

__ District Name / Number: SMUSD 90

Contact Name: Crystal Mondragon

Come «nt

Warrant Void/Stop Request

Finance Desk
ram 20201016

Attachments:
[| Original Warrant

lv] Lest Warrant Affidavit (required for ALL reissues)
[| Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee = 2 9
{starting with “37") tmm/dd/yyyy) {os it eppears in Check Manager} 2 a 3
3700800472| 9/4/2024 | $ 98.05 LEANN MARTINEZ O ©

Notes: Check was lost.

District Approvers po

Cex ;
am

Date: 9/6/2025

For Internal Use Only

Clerk of Board Date:

Void Report Date:

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,

LEANN MARTINEZ (1), being first sworn, upon oath deposes and says:
Narie/Claimant

On or about a @) ) (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, ar 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 him/her in the sum of $98.05 (3)
Signed: Kaan sXe (4)

(5) Subseribed and sworn to before me this A day of August 2025.

NOTARY peBLIC— ———*
My commission expires; NOTA ls AOA
jericopa Coun!
a $, Zork commission # 673439 4°

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

Neranigan (3700800472

8/7/25

Original Date of Issue
ane sinown) 9/4/2024 ;

Reason for original issue of Warrant/Check (8):
C1 Payroll

i For Services or Goods furnished REIMBURSEMENT
Other: REIMBURSEMENT

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 ARS, 11-632 & 15-999

FY) iccosatt Dyriancics 48 - baricona Association of Governunmenis, &F (IRSEVO AK ACSI: Session Ht - 231) - LL - metal
re) i‘ Warrant (1 - mcto) - Warrant number: 3700800472, Stopped
: | Warrant |
Kiki vey die, OF
Warrant | Status | Print | Attachments
7
N Maintain New Status | Setup | Attachments ee _
~~ 3700800472
é Fa remensen er
pon 4 Warrant header
General Posting
a ac Warrant number: Invoice:
A Holder: Invoice date:
aq Issued date: 9/4/2024 12:00:00 am Paid date:
4 Status: Stopped Positive pay sent date: 9/5/2024 12:00:32 pm
- Exception flag: Lt Agency details
Exception reason: None

Queued far positive pay: b-|

Locked for reconciles

| |

Agency voucher number: 2508
Agency claim number:

Agency low orig:

Agency PO number:

Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0

Annual interest rate: 0,00000

C] Amount - Payee Account

98.05 LEANN MARTINEZ