REDACTED-FOR AGENDA ATTACHMENT-JACKSON WHITE PC TRUST ACCOUNT OF -CK#3010160791.PDF
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MAR COPA COUNTY Office of Budget & Finance 301 W. Jefferson St., 9" Floor Phoenix, Arizona 85003 P: 602-506-3561 F: 602-506-4451 Maricopa.gov To: Clerk of the Board From: Office of Budget & Finance, Accounts Payable Date: 03-25-25 Subject: Affidavit — Jackson White PC Trust Account Of Please find attached one Affidavit for a Stale-Dated warrant to be included on the next available Board Agenda. e The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. e The original warrant is presumed lost. Please call Marcia Bulanda at 506-7291 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor. Thank you. Re: FUND 234 — D640 Transportation ~ GAX1D 24*4443 — CV2023-012227 D24579, APN: 304-72-03 CV2023-012227 Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/ Claim Form This application is for: CI Duplicate or Stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is page 2 of this form. JACKSON WHITE PC TRUST ACCOUNT OF (1) being first sworn, upon oath deposes and says: Name/Claimant On or about 14-Sep-2023 (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, er 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 ued to hin n/her wy Sum pf $85, 498.00 (3) “~S flag Z Li ca ct Vln (4) Note: Please attach a copy of the watrant/check if available and/or any other evidence that a warrant/check was originally issued. Signed: — (5) Subscribed and sworn to before me this 1A day of Wa CLA 20.245, UL yy oy NOTARY PUBLIC BILLIE MEAGHER Notary Public - Arizona Maricopa County My Commission Expires 02/18/2028 Commission # 661161 My. Olas pies: d2)\8 (seal) Warrant/Check Number 3010160791 (if known) (6) Original Date of Issue (if known) (7) 14-Sep-2023 Reason for original issue of Warrant/Check (8): (1 Payroll O For Services or Goods furnished, 1 Treasurer's refund/payment ral Other: Fund 234- D640 TRANSPORTATION - GAX1D 244443 - GV¥2023-012227 TT0630 D24579, APN: 04-72-03 CV2023-012227 ADAM M. ASHBY JACKS O NWHITE ERIC K. MACDONALD JOHN K. DOSDALL PT ee Ap RAW JON M, McAvoy TIMOTHY W. DURKIN ATTORNEYS AT LAN ANTHONY H. MISSELDINE JARED E, EVERTON A Professional Corporation KELSEY M, MISSELDINE ZOE N. FIGGIns Monica A. NOLAN JEREMY-S; GEIGLE MICHAEL R, PRUITT: NATHANIEL J. HILL EVAN C, TOMPKINS RYAN K, HopGes DAVID L, WEED TRAVIS W. JENSON ASHELEE J. WEEKS COLTON B, JOHNSTON SPENCER M, WILKINSON March 19, 2025 Jennifer Rodriguez Maricopa County Real Estate Department 2801 West Durango St. Phoenix, AZ, 85009 PROJECT : TT0630 — Item# D24579 CV2023-012227 PARCEL NO : 304-72-031B CLIENTS : BLEVINS FAMILY TRUST JEFF & CHERYL BLEVINS Hi Jennifer! Attached please find the Affidavit/Claim Form signed by Attorney Anthony Misseldine and notarized regarding Warrant Number 3010160791 dated September 14", 2023 in the amount of $85,498.00 made payable to Jackson White PC, Trust Account of. Also attached is notice by Brad Black as Firm Administrator of Jackson White PC authorizing Attorney Anthony Misseldine to sign the affidavit on behalf of the business. Thanks! LOENDY MMISSELDINE Wendy Misseldine Enclosures : Signed/Notarized Affidavit/Claim.Form Notice By Jackson White Fitm Administrator Brad Black 480.464.1111 E-Mail: firm@jacksonwhitelaw.com Toll Free 800.243.1160 40 North Center Street, Suite 200 * Mesa, Arizona 85201 www, jacksonwhitelaw.com Fax 480.464,5692 Serving clients throughout Arizona www.arizonaseniorlaw.com COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY PHOENIX, ARIZONA vey UN SY DATE (Y-14-2023 Eighty Five Thousand Four Hundred Ninety Eight And 00/400 Dollars PAY TO THE ORDER OF Jackson White PC Trust Account of Void After 365 Days WARRANT NUMBER 3010160791 94-2/4224 $85,498.00 AMOUNT For Questions - 602-506-1379 or email AP@MAIL.MAR(COPA.GOV NOT NEGOTIABLE MARICOPA COUNTY DEPARTMENT OF FINANCE, RETAIN THIS POR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT YOUR RECORDS Jackson White PC 3010160791 09/14/2023 $85,498.00 INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT CV2023-01 2227 CV2023-012227 TT0630 D24579, APN: 304-72-0; }GAX1D D640 240000004443 85,498.00 240000004443 CV2023-012227 PU ADAM M., ASHBY JOHN K, DOSDALL TIMOTHY W. DURKIN JARED E. EVERTON ZOE N, FIGGINS JEREMY S: GEIGLE NATHANIEL J. HILL RYAN K, HODGES TRAVIS W. JENSON COLTON B. JOHNSTON DATE : March 19, 2025 JACKSONWHITE ORNEYS AT LAW A Professional Corporation March 19, 2025 Eric K. MACDONALD JON M. McAvoy ANTHONY H, MISSELDINE KELSEY M. MISSELDINE Monica A. NOLAN MICHAEL-R, PRUITT EVAN C, TOMPKINS DAVID L, WEED ASHELEE J. WEEKS SPENCER M. WILKINSON I, Brad Black, authorize Anthony Misseldine, Attorney, to execute an affidavit on behalf of Jackson White PC. Yours truly, G Wok Brad Black Firm Administrator of Jackson White PC 480.464.1111 Toll Free 800.243.1160 Fax 480.464.5692 40 North Center Street, Suite 200 * Mesa, Arizona 85201 Serving clients throughout Arizona E-Mail: firm@jacksonwhitelaw.com www.jacksonwhitelaw.com www.arizonaseniorlaw.com (CO) Agency Status gt Tory 4 Warrant number © Issued date [ag101go7@1 | Stale a eel ‘Narrant nuriber 301016 Amount Payee 460.00 Jackean White PC Account