STAMPED & REDACTED- NAYDA LOPEZ.PDF

MARICOPA COUNTY

Office of Budget and Finance
301 West Jefferson, 9" Floor
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: October 27, 2022
To: Clerk of the Board
From: Marcia J. Bulanda

Office of Budget and Finance

Subject: Affidavit - NAYDA LOPEZ

Please find attached 1 Affidavit for a lost 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 lost.

Please call me at 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 222 ~ D220 HUMAN SERVICES — GAX1D 22*22448
RENTAL ASSISTANCE FOR NAYDA LOPEZ-CASE# CAS-99924-M9M2C7

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: Duplicate or CI 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.
NAYDA LOPEZ

(1), being first sworn, upon oath deposes and says:

Nenie/Claimant

On or about 28-Apr-2022 (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, a 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 $4,950.00 (3)
sane: JA la Hopes (4)

Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

(5) Subscribed and sworn to before me this Sth day of _Octolv 20 dd,

Jerk Stadriyr.
NOTARY PUBLIC SCOTT MULLENBACH
Notary Public - Arizona
aoe . Maricopa County
My commission expires: Commission # 630698
2/ 3 [3036 My Comm. Exp. August 3, 2026 f (seal)
Warrant/Check N 0 ——
atrant/Check Number
yemeck Nu 3010116146
Original Date of Issue ‘
{if known) (7) 28-Apr-2022 10/27/2022
Reason for original issue of Warrant/Check (8): -

{1 Payroll
O1 For Services or Goods furnished

0 Treasuret’s refund/payment
Other; / original check presumed lost in the mail

FUND 222 - HUMAN SERVICES-CLIENT NAME: SOPHIA VALVERDE
RENTAL ASSISTANCE FOR NAYDA LOPEZ - CASE# CAS-99924-MOM2C7

October 25, 2022

To whom may it concern,
I Nayda Lopez is a sole proprietor with no employees. Therefore, I am the only individual that

is able to sign.

Sincerely,

Nayda Lopez

COUNTY expense WARRANT TREASURER OF MARICOPA COUNTY WARRANT NUMBER
PHOENIX, ARIZONA 3010116146
DATE
Woh 202 91-2/1221
Four Thousand Five Hundred Fifty And 00/100 Dollars
$4,550.00
PAY TO THE ORDER OF AMOUNT
Nayda Lopez
Void After
365 Days

NOT NEGOTIABLE

MARICOPA COUNTY DEPARTMENT OF FINANCE

RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT
YOUR RECORDS
3010116146 04/28/2022 $4,550.00

Nayda Lopez
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT

GAX1D D220 220000022448 4,550.00

INV-00005088 13 VALVERDE, SOPHIA RENTAL ASSISTANCE
f 220000022448