REDACTED-FOR AGENDA ATTACHMENT-JACKSON WHITE PC TRUST ACCOUNT OF -CK#3010160791.PDF

Maricopa County — Formal (2025-03-21)

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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