STAMPED & REDACTED ASPEN SQUARE MANAGEMENT INC.PDF

MARICOPA COUNTY
Department of Finance

301 West Jefferson, Ste 960
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: December 22, 2021
To: Clerk of the Board
From: Maria Meza

Department of Finance/Accounts Payable

Subject: Affidavit- ASPEN SQUARE MANAGEMENT INC W#3010101946 11/02/21 $3423.60

Please find the attached Affidavit for a duplicate reissue to be included on the next

available Board Agenda.

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

e The original warrant is lost.

Please return the approved Affidavits to my attention in the Department of Finance, Suite
960 or email to MARIAAMEZA@MARICOPA.GOV.
| may be reached at 602-506-1379 if you have any questions.

Thank you.

Re: Reissue to VC-13136 ASPEN SQUARE MANAGEMENT INC
Remit AD-0003 Riverwood Apartments

Rental Assistance- Miranda Merchant

D220 GAX1D 22-8289 FUND 222

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

This application is for: Duplicate or Cl stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to

COUNTY OF MARICOPA numbers on the Instruction sheet which is
page 2 of this form.

being first sworn, upon oath deposes and says:

Vo-13136 ASPEN SQUARE MANAGEMENT INC (4
NamelClaimant ,

On or about 92-Nov-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/check be issyed to him/her in the sum of $ 3,423.60 .(3)
Signed: QW? (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 to before me this (oa day of [) <a 20 =

eid PZie it

NOFARY PUBLIC
JOSHUA MOFFITT
M commission ex He TO PACOUNTY
MARICO!
y 7 P EA Gommiselon # 586449

Expires July 22, 2024 (seal)

Warrant/Check Number 19949491946

(if known) (6)

Original Date of Issue :
(if known) (7) 02-Nov-2021

Reason for original issue of Warrant/Check (8): / 12/23/2021

1 Payroll
1 For Services or Goods furnished

O Treasurer's refund/payment
Other: 0220 GAX1D 22-8289 RENTAL ASSISTANCE: CK NVR RCVD RE:Miranda Merchant —

ASPENSQUARE

MAKAGEMENT

\A-VW6 a9)

|, Natalie Jones, authorize Jalisa Morant, Community Manager, to execute and affidavit on behalf of
Aspen Square Management.

Natalie Jones

District Supervisor
4

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