STAMPED & REDACTED - MISTY MOORE.PDF
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v MAR)COPA INTEROFFICE MEMORANDUM TO: MARICOPA COUNTY CLERK OF THE BOARD FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA) SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS DATE: 05/15/2025 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. If you 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 Buckeye Union Dist #201 | Moore, Misty 3700765762 $391.12 Date Amount Reissue WT # Office of the Maricopa County Finance Desk School Superintendent mm 20201016 Warrant Void/Stop Request District Name / Number: Buckeye Union High School Dist. #201 Attachments: Contact Name: Laura Blake [] Original Warrant Contact e-mail: Po [xx] Lost Warrant Affidavit (required for ALL reissues) xx] Vendor Letter (if requesting Vendor reissue) Warrant Number Warrant Date | Amount Payee ce} a2 © (starting with “37") (mm/dd/yyyy) (as it appears in Check Manager) 2 & 3 é 3700765762 05/16/2024 391.12 MISTY MOORE © O ©oU ©OU ©OU Notes: CHECK LOST PLEASE REISSUE District Approver: Date: 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. MISTY MOORE : 5 NamaKiawnant (1), being first sworn, upon oath deposes and says: On or about 05/16/2024 (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/ch efits aia: hint/Rer i in the sum of $ 391.12 (3) Signed: UA nN ra ! i he (4) 4 3 ¢ % : = = ] ( cribed and sworn to before me this ue day of Nau 2025. Gi iy JESSICA ZUNIGA (Sie () Nota Putte hfe My commission expires: wares ary 198, 20 (= Expires Aug 18, 2026 ( (seal) Note. Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number _ | (if known) (6) 3700765762 Original Date of Issue tear 05/16/2024 Reason for original issue of Warrant/Check (8): C Payroll / 5/15/25 O For Services or Goods furnished | . XX Other: REIMBURSEMENT S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S, 11-632 & 15-999 5/15/25, 1:20 PM Warrant (1 - mcto) - Warrant number: 3700765762, Stopped ti Ld o =| a Warrant = Status Print = Attachments v Maintain __ New Status Setup Attachments _ 3700765762 a Warrant header General Warrant number: Holder: Issued date: 5/16/2024 12:00:00 am Status: Stopped Exception flag: Exception reason: None Queued for positive pay: Locked for reconcile: Registered Date registered: No of days interest: 0 Annual interest rate: 0.00000 a Warrant Lines [ri Amount Payee 391.12 MISTY MOORE https://horizon.maricopa.gov/portal/webclient/#/desktop VMware Horizon Posting Invoice: Invoice date: Paid date: Positive pay sent date: 5/15/2024 09:00:16 am Agency details Agency voucher number: 2790 Agency claim number: Agency low orig: Agency PO number: Agency sub fund: Agency dept num: Account 1/1