STAMPED & REDACTED CHALLENGE ISLAND CHANDLER.PDF
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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. v 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. #95 Queen Creek Unified Challenge Island Chandler $1,250.00 RECEIVED DEC 15 2021 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS Falor ofliee teal -AE 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. Stephanie Edwards DBA Challenge Island Chandler (1) being first sworn upon oath deposes and says: Name/Claimant " ‘ On or about December 1, 2021 (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/cheok be issued to him/her in the sum of $ 1250.00 (3) } . Signed: Aidan 10 Duy Oiol— (4) iv (5) Subscribed and sworn to before me this__ _ _day of Decemleew 2021. NOTARY PUBLIC Va My commission expires: 7 / 27 / 2025 December 1, 2021 Nolary Public - State of Arizona MARICOPA COUNTY Commission # 610652 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 3700484804 (if known) (6) Original Date of Issue : . hare invoice date 10-22-2021 Reason for original issue of Warrant/Check (8): 0 Payroll For Services or Goods furnished_10-22-2021 12/21/2021 1 Other: 10-22-2021 : - S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Chéwiw eure ve cme Revised June 2015 ARS. 11-632 & 15-999 Challenge Island Chandler Stephanie Edwards- owner December 7, 2021 Dear QCUSD, This letter is to inform you that I am the owner representative of Challenge Island Chandler authorized to sign for the entity asking for a warrant check replacement #3700484804. I completed the form with a notary to have a re-issue of lost/not received check in the amount of $1,250.00 for a field trip at Desert Mountain Elementary on October 22, 2021. My invoice number was #108 billed directly to the school attention of Michele Olsen. If you should need anything further please let me know. Sincerely, Stephanie Edwards