REDACTED-FOR AGENDA ATTACHMENT-LIFES ASSOCIATES LLC- #956020.PDF
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MAR)COPA COUNTY
TREASURER’S OFFICE
John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003
Phone: (602) 506-8511
To:
Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov
From: Treasurer's Office
Maria Quitangon iw
maria.quitangon@maricopa.gov
602-506-1958
Cathy Sanchez a
cathy sanchez @hmrari a.gov
602-506-7881
Re: Stale Dated Warrant
Name
Warrant
No
Amount | Dept/School
LIFES ASSOCIATES LLC
956020
$26.71_| Treasurer
STEPHEN WALKER
Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form
This application is for: oO Duplicate or x Stale-Dated (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.
ih | FES Seciate § (1), being first sworn, upon oath deposes and says:
Name/Claimant |
On or about hi | } W238 (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 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 issued to him/her in the sum of $. (a b ~ 7 | .(3)
Signed: 5 Shwe IK we (4)
Print name: (required) Shop \ uw A. Wa (kK ev
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) rea and sworn to before me this / 7 +4 day of mM ape 20 2S.
NG ee
NOTARY PUBLIC
My commission expires:
ss -
(seal)
Warrant/Check Number ,
(if known) (6) GF 56 OZ 0
Original Date of Issue
(if known) (7) 4 [F [2 0-3
Reason for original issue of Warrant/Check (8):
O Payroll
O For Services or Goods furnished.
4 Treasurer's refund/payment
O Other:
‘S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 ARS. 11-632 & 11-644
eres?
4 lchS
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Maricopa County Treasurer's Office
502-62-001Y 1 3/26/2025 12:11:26 PM
Fund: [50
|B 502-62-0017 1 - x
| File Help
| || Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act
| 2024 TAX PAYMENT 2024-11-12 0052-57090 $12.68 N 2024-10-31 1 |
2023 TAX PAYMENT 2024-11-12 = 052-57090 $13.89 N 2024-10-31 1
2024 TAX BILL 2024-08-24 Y
2023 = =DELINQUENT NOTICE 2024-06-03 v
2023. TAX BILL 2023-08-2 v
2021 REDEMPTION PAYMENT 2023-03-22 0711-04434 N 2023-03-17
2022. TAX PAYMENT 2023-03-22 0011-04434 $12.25 N 2023-03-17 1
2021 BTx_IMPOUND 2023-02-27 053-68635 $11.29 ¥
Parcel #: (502-62-001Y Activity: JREFUND Act Date|04/07/23
Tax Year: 2021 Tran #:[- fa Act Time {12:00 AM
Activity Detail | Address Detail |
= eo |
cP #: [21016027 Check Date: ‘joaar23
Buyer #: 20653 Check #: [3se020°
Click icon for Disbursements Inquiry. ----->
Refund Amount: | 82671
View Image... Close
Maricopa County Treasurer's Office
12:11:01 PM
1 Refund ID 2023004722 CP_BUYER
| File _Help
SIR
Refund ID 2023004722 CP_BUYER
Refund Amount: a
Requester: JAN ETTE.CANCEL on 3/22/202.
| Refund Reason: |cr Redemption refund
|
Status: [DISBURSED on 4/7/2023
Slip 1D: {202300172
Address: fe
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[eles
{
'
Impounds | stub | Comments }
Check Request: [MAIL
Reference #: \cp 21016027
Source Fund | Linked | Amount { Tax Year | Status
050 True $26.71 2021 READ*
Impound Total : 1
Impound #1
Parcel/Roll:|502-62-001Y Dest fund: {050
CP #: 21016027 Resott: [0
cp buyer # [20652 Phase #: oO
Mortgage code :
Transaction # : Ja 104434
Case #:
Close
3/26/2025
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Maricopa County Treasurer's Office
Bsc
Name/Address
Copy
Name/Address
ERs List
Buyer Number: | Pi Buyer Code: fr a
I¥ Outstanding [~ Redeemed [~ Expired [~ Extinguished
IRS Form Type fw
CP Number | Parcel Number | # of Years | Status
23009553 12621028
23011506 14708003
22011479 147080098
23004841 147080098
22011480 14711010
23004842 14711010
22011483 14716020
23004843 14716020
1
1
1
1
1
1
1
1
Qutstanding
Outstanding
Outstanding
Outstanding
Outstanding
Outstanding
Outstanding
Outstanding
Number of C.P.'s Displayed: 8
Close
3/26/2025 12:12:16 PM