STAMPED & REDACTED ASPEN SQUARE MANAGEMENT INC.PDF

MARICOPA COUNTY

Office of Budget and Finance
301 West Jefferson

Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: July 29, 2022
To: Clerk of the Board
From: Walter Chang

Office of Budget and Finance

Subject: Affidavits —- Replacement of Lost Warrants

Please find attached 1 Affidavits for lost warrants to be included on the next available

Board Agenda.
e Theattached items have been researched to ensure the warrant in question
have not been cashed or previously re-issued.

e The original warrants have a void/stale date/stop payment done.

Please call me at if you have any questions. Please return the approved
affidavits to my attention in the Office of Budget and Finance.

Thank you.

Re: Fund: 222 / Dept: Human Services

Company : ASPEN SQUARE MANAGEMENT INC

Application for a Duplicate or Stale-Dated Warrant/Check
Affidavit/Claim Form

This application is for: Duplicate .or [J staie-patea (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
pade 2 of this form:

ASPEN SQUARE MANAGEMENT INC (1), being first sworn, upon.oath. deposes and. says:
Name/Claimant

On or about 02-Jun-2022: -(date)(2). a warrant/check: was issued to: the

above nathed 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

iyo reasonable probability‘of its being found or présented for payment, oF 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 $9,171.40 3)
Nats Please “rol 2 4 copy of Ea warrant/chéck if available and/or any other

evidérice that a warrant/check was originally issued.

(5) Subscribed and sworn to before methis_2.¢ day of Te f 20.

NOTARY PUBLIC‘

My com expires:
POSS i
Warrant/Check Number | 3949448749

(if known) (6)
Original Date of Issue .9n-
(if known) (7) 02-Jun-2022

JOSHUA MOFFITT |
Notary Public, State of Arizona
Maricopa County
Commission 586448
My Commission Expire: 5
¥ wduly 22, 2024 (seal)

Reason for original issué of Warrant/Chéck (8):

C1 Payrall
For Sérvicés or Goods furnished _/ Thompson, Myra RENTAL ASSISTANCE

GO) Treasurer's refund/payment
Other: / check presumed lost/ fund: 222

- 07/29/2022

4! Ld ae

r

ASPENSQUARE Jf

MAGADEMENT

7/26/2022

Maricopa County Office.of Budget and Finance
Attn: Accounts Payable

|, Wendy Touchette, authorize Hailey DeLacy, community manager and administrator, to
execute an affidavit on behalf of Buckeye Avenue 33 LLC d/b/a. Riverwood Apartments.

Thank you,

Wendy Touthette
‘Treasurer

ANDREA M. MCRITCHIE
‘Notary Public:

(ih Jeomnensast of’ Massachusetts
y Commission Expires
Mepienber 80, 2022