STAMPED & REDACTED ELISABETH G MINZER.PDF

INTEROFFICE MEMORANDUM

Maricopa County Schools Superintendent Office

TO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 1/4/2022

Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next
available Board agenda

v The attached item(s) have been researched to ensure that the warrant(s) in question have
not been cashed or previously re-issued.

Vv The original warrant(s) have had a stop payment done.

If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at
terri ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor)

Thank you.

#2 Riverside Elementary Elisabeth G Minzer $196.18

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form,
ELISABETH G MINZER (1), being first sworn, upon oath deposes and says:

On or about NOVEMBER 22, 2021 (dete)(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 Cesirover ene Grecn os
no reasonable probability of its being found or presented for payment, ar 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 $ 196.18 _.(3)

ood,

NOTARY PUBLIC J) ve"

ARITTANY QUISBERG,
Notary Public» Atizona
Maricopa County
Commission # 569994
Ay Comm, Expires Sop 10, 2023

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

Warrant/Check N ~ anasqoay

rantiemeck number | 3700489291 01/04/2022
Original Date of Issue Gags = -
Reason for original issue of Warrant/Check (8): O

D Payroll

O For Services or Goods furnished EXPENSE REIMBURSEMENT
Other: EXPENSE REIMBURSEMENT ;

S;\PROCESSES\Warrants - Duplicate or Stale\o2 Forms\Schools\Schools-Warrants Che It
Ruleed line tte \ Checks notice of Atades ieWass9s

siasesal pepe variant 3700489291

TREASURER OF MARICOPA COUNTY

91-2/1221 F

IRAP eta Ug NU at eure ae mare eawrbaive_| 4

11/22/2021 2085387 | 2

8

Riverside Elementary District #2 °

AY WARRANT AMOUNT fi
“One Hundred Ninety Six and 18/100 Dollars $196.18 i

| VOID AFTER 865 DAYS z

oO MINZER, ELISABETH G \ 5
IRDER () st # 5 2
¥ 2 Fi

Foo cette we Me, siti ce sinatunes |

. 11/22/2021 Check: 2055387 EXPENSE
MARICOPA COUNTY SCHOOLS PHOENIX, ARIZONA AP 20211123 3700480291
MINZER, ELISABETH G | |_avearao21_| |
Payee | [Check Date [ |
Account Number PO Number invoice Amount
22437 Reimb/Exp/22337 196,18
| PAM 4

\ ; #3 Wei
, NOV Be

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BUSINESS SE SERVIC ES |

quer TEETER
VOUCHER: 1048 TOTAL: $196.18

HARLAND CLARKE M22692 00229286