REDACTED-FOR AGENDA ATTACHMENT-THOMAS JOSEPH TRZASKA-#964460.PDF

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MARICOPA COUNTY

TREASURER’S OFFICE

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003
Phone: (602) 506-8511
http://treasurer.maricopa.gov

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer's Office
Maria Quitangon ree
maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez Qy”

cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name

Warrant
No

Amount

Dept/School

THOMAS JOSEPH TRZASKA

964460

54.11

Treasurer

L
MA R) COPA Application for a Duplicate or Stale Dated

COUNTY Warrant/Check Affidavit/Claim Form
This application is for L] Duplicate or [Ctate-Dated (definitions are on page 2)
STATE OF ARIZONA Note: Numbers on this form correspond to the numbers
COUNTY OF MARICOPA on the Instruction sheet which is page 2 of this form
The mAs 7 ReAst jy (1), being first swron, upon oath deposes and says:

Name/Claimant

On or about // -6-Zo Z3 (date) (2) a warrant/check was issued to the above named
person/entity in the amount 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 issues to him/her in the sum of $ SY. 4) . (3)

Signed: TWhienred / UiZ>) aha (4)

Print Name: (required) THE MAS TRZASEA

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

? PLE a ae
(5) Subscribed ana befor: this Z2 & day of July 20.25.
poo
NOTARY PUBLIC “~ dauiee Calne
eae W etd PALMA
My commission expires: cS) ei er
ENS riot seal
Maren 4, 2027 S Pomel pes =
Warrant/Check Number
(if known) (6) Po 4¢¢ 60
Original Date of Issue
(if known) (7) Nov 06, 2023
Reason for original issue of Warrant/Check (8):
O Payroll

a Services or Goods furnished
T

reasurer’s refund/payment

OO Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc Revised
100518 VERMELED

ARS. 11-632 & 11-644 qiealas PO

(HB 300-20-040 6

File Help
Year [ Description | Act Date | Tran Num [ Amount | Images | Pmt Date | Half Code | Act
2024 ~=CP BUYER PAYMENT 2025-06-30 0096-69441 $1,106.31 N 2025-06-30 F 23 |
2024 = =DELINQUENT NOTICE 2025-05-15 Y 12:1
2023. =CP BUYER PAYMENT 2025-02-04 + 087-00098 $613.57 N 2025-02-04 2 10:!
2023 = DELINQUENT NOTICE 2024-11-20 Y 12:1
2024 = TAXBILL 2024-08-24 Y 12:1
2023 =DELINQUENT NOTICE 2024-06-03 Y 12:1
2021 REFUND 2023-11-06 : $54.11 N 12:1
2021. REDEMPTION PAYMENT 2023-10-20 = 072-40981 $64.11 N 2023-10-17 6:4:
2023. TAX PAYMENT 2023-10-20 = 072-40981 $501.61 N 2023-10-17 1 6:4:
Parcel #: |300-20-040 Activity: [REFUND Act Date‘11/06/23
Tax Year: [2021 Tran #:[- Act Time‘i2:00 4M
Activity Detail | Address Detail |
CP #: [21013372 Check Date: [11/06/23
Buyer #: [6975 Check #: [964460
Fund: {50 Refund Amount: $54.11
& Refund ID 2023018375 CP_BUYER = Oo x
File Help
4a
Refund Amount, [$54.11 Requester, [CCARDWEB on 10/20/2023
Refund Reason: \cr Redemption refund Status: [DISBURSED on 11/6/2023
Slip 1D; [202300516
Address: [TRZASKA THOMAS JOSEPH Check Request: |MAIL
Reference #; |CP 21013372
Impounds | Stub | Comments |
[ Impound #1

Source Fund | Linked [

Amount | Tax Year | Status

050 True $54.11 2021

READ‘

Impound Total : 1

Case #:

Parcel/Roll :|300-20-040
CPH:
CP buyer # [6975
Mortgage code : a_v__

Transaction # :

Dest fund : [050
Reso #: Jo
Phase #: [0

[21013372

07240981