STAMPED & REDACTED - BRADY INDUSTRIES OF ARIZONA, LLC.PDF

INTEROFFICE MEMORANDUM 
TO: 
MARICOPA COUNTY CLERK OF THE BOARD 
FROM: 
MCSS FINANCE DESK (ANDIE DE LA ROSA) 
SUBJECT: 
AFFIDAVITS – REPLACEMENT OF LOST WARRANTS 
DATE: 
05/20/2025 
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 
Wickenburg Dist #9 
Brady Industries of Arizona, LLC 
3700808738 
$183.92

Schools Affidavit/Claim Form
Application for a Duplicate Warrant/Check lo"tinitions are on page 2)
Note: Numbers on this form correspond to numbers on the
lnstruction sheet which is page 2 of this form.
BRIIJ IND-Y:rRIES oF ARlzoNA' LLC (1), being first sworn, upon oath deposes and says
on or about lD
(aate)(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, g¡ 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/
be issued to
m/her in the sum of
183.92
Signed:
4)
Note.' Please attach a copy of the warant/check if available and/or any other
evidence that a warrant/check was orþinally issued.
Reason for original issue of Warrant/Check (B):
n Payroll
E For Services or Goods furnished
n Other:
SÏATE OF ARIZONA
COUNTY OF MARICOPA
(3)
Notbry Public-Strtê ol
¡ppr. to. 23-5393-0l
z
MvAppl.
o1-11-2027
202f-.
(s)
BLTC
(seal)
N
ires
My
bscribed and sworn to befqre me this -Ø!_4uv or
commissíon
/-//-
Warrant/Check Number
(if knownl 16l
3700808738 I 9624379
Original Date of Issue
(Íf known) 17)
1010112024
S:\PROCESSES\Warranb - Duplícate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised lune 2015 
A.R.S. 11-632 & t5-999