STAMPED & REDACTED ALBERTO PANTOJA .PDF

Maricopa County
Human Resources

Viemo

To: Juanita Garza, Clerk of the Board
From: Monica Reyes
Date: April 26, 2022

Re: Replacement of Lost Payroll Warrants

Please find attached _ 1 Affidavit/Notice of Claim(s) for lost

payroll 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.

Please call Monica at ext. 68051 for any questions. Please route
approved Affidavits back to County Payroll, Suite 400.

Stale Dated Warrant Duplicate Warrant

Thank you.

Replacement Lost Warrant Form 4 02/25/2015

04/27/2022

( Paycheck View

Name Pantoja,Alberto Confirmed Check
Check# Issue Date Earnings Taxes Deductions
23125195 04/13/2022 956.27 98.98
‘ Regularand Overtime Eamings - oe 7 ~ Taxes —
RegHours  RegPay = OT Hours. OT Pay _ FED SSDisMLVEE
FED MedicareEE
40.00 891.20 * FED SS/Dis ER
* FED MedicareER
AZ Withholdng
r Other Earnings ——_,, r Deductions
Code _ Hours __Amounts Add to Gross * 57 Nontaxable
AWP 1.00 22.28 Y * 90ER Nontaxable
OTP 1.25 41.79 Y * 9{ER Nontaxable
SH1 2.00 1.00 Y
|

ADP Enterprise HR screen print as of: 04/25/2022 09:06 AM