REDACTED - FOR AGENDA ATTACHEMENT OLD TOWN REPUBLIC TITLE AGENCY COMPANY.PDF

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

INTEROFFICE MEMORANDUM

Date: October 19, 2022
To: Clerk of the Board
From: Marcia J. Bulanda

Office of Budget and Finance

Subject: Affidavit— OLD REPUBLIC TITLE COMPANY

Please find attached 1 Affidavit for a stale dated warrants 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: TREASURER WARRANTSS-VERIFICATION FROM DESI RAMREZ@TREASURER DEPT.-
WARRANTS WERE NOT CASHED. CHECKS WERE CANCELED ON 07-31-2022, STALE
DATED

Application for a Duplicate or Stale-Dated Warrant/Check

Affidavit/ Claim Form

This application is for: ~ | Duplicate or in 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
nade 2 of this form.

OLD REPUBLIC TITLE COMPANY (1), being first sworn, upon oath deposes and says:

Name/Claimiant

On or about 10-Aug-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/chegk be issued to him/her | in the sum of $1,439.45 (3)

Signed: a SINT Lhe ar an (4)

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

(5) Subscribed and s sworn to before me this __| at day of September 99 2%

NOTARY Sg CG
oo JON L. CHRIST
My cefmmission expires: “th Publ - Sisto of iz
cai rere one
Warrant/Check Number
{if known) (6) 9311 256
Original Date of Issue ¢
(if known) (7) 40-Aug-202 1

Reason for original issue of Warrant/Check (8):

2 Payroll
C1 For Services or Goods furnished

C1 Treasurer’s refund/payment
Other: / Original check presumed lost in the mail - Stale Dated

Treasurer Warrant - Verification from Desi Ramrez @ Treasurer Department - Warrant
was not cashed. Check was canceled on 07-31-2022, stale dated.

MARICOPA COUNTY TREASURER

JOHN M. ALLEN, COUNTY TREASURER
SERVICING BANK ACCOUNT

931256
Vendor : OneTime0028430, OLD REPUBLC TITLE AGENCY
Invoice number Invoice date Description Payment amount
2021019366 8/10/2021 APN 17142087 ESC 4717017591 ML jc 1,439.45
Total 7 1,439.45

DETACH AND RETAIN THIS STATEMENT

Bb -2 THIS DOCUMENT CONTAINS A TRUE WATERMARK=HOLO TO LIGHT TO VIEW.” an

MARICOPA COUNTY TREASURER. 931256
JOHN M.-ALLEN, COUNTY TREASURER ACH RIT: 122100024 : : Lee a
SERVICING BANK ACCOUNT. : 91-2/1224 a DATE
: August 10 2021 a
One Thousand Four Hundred Thirty Nine Dollars and 45/100 $1,439.45

ECK VOID AFTER 365 DAYS

PAYTOTHE OLD REPUBLIC TILE (AGE

ORDER OF RICOPA COUNTY TREASURER

, \ a (OHN M. ALLEN, COUNTY TREASURER
Vs At ee

AUTHORIZED SIGNATURE

Application for a Duplicate or Stale-Dated Warrant/Check

Affidavit/Claim Form

This application is for: { Duplicate or in 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

bade 2 of this form.

OLD REPUBLIC TITLE COMPANY (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about Ot-Jul-2021 (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, of it was not

presented for payment within one year after the date of issuance.

Therefore, under penalty of perjury, clairnant hereby affirms that this claim is correct
and the amount shown is due and owing, and the applicant requests that a replacement

warrant/che as be issued to him/her in the sum of $613.97 (3)

Signed: Fsva Mle - (4)

Note’ Please attach a cory Le the warrant/check if available and/or any other
evidence that a warrant/c was originally issued.

(5) Subscribed a Y Dp rn to before me this 13°" day of _S$er%* mber99 Ze,

NOTARY nape

JON L. CHRIST
My commission expires: Nofay Pub State of zona
wh 43028
Warrant/Check Number o. —_ : i
(if known) (6} 928697
Original Date of Issue
(if known) (7) 04-Jul-2024

Reason for original issue of Warrant/Check (8):

1 Payroll
1 For Services or Goods furnished

CO Treasurer's refund/payment
Other: / Original check presumed lost in the mail - Stale Dated

Treasurer Warrant ~ Verification from Desi Ramrez @ Treasurer Departinent - Warrant
was not cashed. Check was canceled on 07-31-2022, stale dated

aie MARICOPA COUNTY TREASURER

JOHN M. ALLEN, COUNTY TREASURER
SERVICING BANK ACCOUNT

928697
Vendor : OneTime0026747, OLD REPUBLIC TITLE AGENCY
Invoice number Invoice date Description Payment amount
2021015678 7/1/2021 Parcel_ 13149068/Esc 4717017522-ML/Overpmt of prop.taxes rm 613.97
Total ; 613.97

DETACH AND RETAIN THIS STATEMENT

MARICOPA COUNTY TREASURER _ . . 028697 |

+ JOHN M. ALLEN, COUNTY. TREASURER : s a : oe
SERVICING: BANK:ACCOUNT = 91-2/1221-- a ‘ = DATE

July 01 2021
$613.97

CHECK VOID AFTER 365 DAYS

Six Hundred Thirteen Dollars and 97/100

MARICOPA COUNTY TREASURER .
JOHN M, ALLEN, COUNTY TREASURER E

pam ee

AUTHORIZED SIGNATURE ! Fa

PAYTOTHE © OLD REPUBLIC
ORDER OF :

1%

x *
x, OLD REPUBLIC TITLE AGENCY

Kae k

September 13, 2022

Attn: Marcia Bulanda
Maricopa County Department of Finance

Re: Escrow No.: 4717016125-ML
Property:

Dear Ms. Bulanda

Attached are the executed affidavits to reissue the stated checks as shown in each form. The forms were
signed by Rosemarie Jones, Vice President of Old Republic Title. Our corporate resolution naming her as an
authorized signer is also attached,

I have also included the stale dated checks, marked "VOID."

Please reissue the checks and mail them to my attention. Should there be any questions, please contact me at

Thank you.
/ Sincerely, ,

“Jén‘Christ
Branch Manager

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