STAMPED & REDACTED FRANCES F. VACANERI .PDF

MARICOPA COUNTY
Department of Finance

301 West Jefferson, Ste 960
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM
Date: April 25, 2022
To: Clerk of the Board
From: Joyce Maurmann

Department of Finance

Subject: Affidavit - Replacement of stale dated Warrant

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

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

e The original warrant was lost and not received by vendor

Please call me at 506-1343 if you have any questions. Please return the approved

Affidavits to my attention in the Department of Finance, Suite 960.

Thank you.

Re: FRANCES F VACANERI
D220 GAX1D 22*15911 FUND 296

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

This application is for: EX Duplicate or C1] stale-Datea (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA cae er thie to instruction sheet which is
FRANCES F VACANERI (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 08-Feb-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, 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/cl 4 be issued C0 phe the sum of $3, 850.00 (3)

Signed: GAirtia OL; Ledde ty. (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 i ‘ore me this 42 bay of APRIL.
AL phe —

NOTARY PUBLIC : NY MOLINA

Notary Public - Arizona
Maricopa County

woe : . = i) Commission # 561759
My commission expires: Ses My Comm. Expires Mar 28, 2023
f (seal)
7

Warrant/Check Number 301 01 09473

(if known) (6)

Original Date of Issue
(if known) (7) 08-Feb-2022

Reason for original issue of Warrant/Check (8): 04/26/2022

OO Payroll
For Services or Goods furnished

O Treasurer's refund/payment
Other, ORIGINAL CHECK PRESUMED LOST

April 12, 2022

Frances F Vacaneri

Maricopa County Office of Budget and Finance
Attn: Accts Payable

|, Frances F Vacaneri, am a sole individual who owns and rents out and manages the property for which

| am seeking payments for rents owed and are the subject of this lost check.

Thank you,

LL ls
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WA
WZ) . Vijcor bh

tances F Vacaneri

Subscribed and sworn to before me this A 1 imp © on Arc 2022

Notary Public E% JIMMY MOLINA
” debe " gas 1) Se

Commission 4 561759
Leyes My Comm, Expires Mar 28, 2023

My commission expires: