STAMPED & REDACTED TOWN OF WICKENBURG.PDF

Maricopa County — Formal (2022-01-12)

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INTEROFFICE MEMORANDUM

Maricopa County Schools Superintendent Office

TO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 12/13/2021

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.

#9 Wickenburg Unified Town of Wickenburg $1,157.40

CEC 21 2024

MARICOPA COUNTY

CLERK BOARD OF SUPERVISORS

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.

Town of Wickenburg/Stacey Canary (1), being first sworn, upon oath deposes and says:
Name/Claimant ™

On or about (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/check |b issued to hirh/her in the sum of $1,157.40 (3)

Signed: . ley LNW (4)

(5) Subscribed and‘sworn to before me = aq day of November 20.2).

See

NOTARY PUBLIC

My commission expires:
D2Q/O//202S

AMY BROWN
Notary Public, State of Arizona’
Maricopa County
Commission # 696310
My Commission Expires
February 01, 2025 (seal)

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

Warrant/Check Number
(if irony i6) 3700483934

Original Date of Issue
Be einen th 11/4/2021

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

For Services or Goods furnished Utility bill
O Other; Utility bill

12/21/2021

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 A.R.S. 11-632 & 15-999

Town of Wickenburg

Stephanie Wojcik, Finance & Technology Director

DATE: November 29, 2021

TO: Wickenburg Unified School District/Maricopa County
FROM: Stephanie Wojcik, Finance & Technology nang fait

RE: Replacement Check for Unpaid Utility Acct # 15.00308.00

This letter is to confirm Stacey Canary, Senior Accountant for the Town of Wickenburg, is
authorized to pursue unpaid claims for utility services and other accounts receivable services.
On behalf of the Town she is authorized as a signer for unpaid claims.