STAMPED & REDACTED - FOR AGENDA ATTACHMENT - FUTURE HEARTS, MINDS & DREAMERS.PDF

Office of the Maricopa County

School Superintendent
Steve Watson

INTEROFFICE MEMORANDUM

TO: MARICOPA COUNTY CLERK OF THE BOARD

FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA)

SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS

DATE: 11/14/2024

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

If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or
via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the

Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100.

Thank you
District Payee Warrant # Amount
Osborn Dist #8 Future Hearts, Minds & Dreamers 3700810940 $600.00

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

Warrant Void/Stop Request

District Name / Number: Osborn School Distrcit #8

Contact Name: Yyonne Lopez

mmeenes Po

Attachments:
[| Original Warrant
Lost Warrant Affidavit (required for ALL reissues)

[ ] Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount
(starting with “37”) {mm/dd/yyyy)

Payee
{as it appears in Check Manager)

Void
Stop
Re-issue

3700810940) 10/8/2024 | $ 600.00) FUTURE HEARTS, MINDS & DREAMERS|@) ©)

©OU

©OU

©OU

Notes:

Lost in mail. Never received. Please

re) SSS,

District Approver: eer «) Nosego Date: || | ee \ 24

For Internal Use Onh

Clerk of Board Date:

Void Report Date:

Schools Affidavit/Claim Form

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

STATE OF ARIZONA Note: Numbers on this forn correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.

Future Hearts, Minds, & Dreamers (1), being first sworn, upon oath deposes and says:
“ a”

Name/Claimant -

On or about 10/8/24 | (date)(2) a warrant/check was issued to the
rommmneemrennemenen= BOOS Tailed Person/Sritity TH The Sinonnit as Stated Below.” Such Warrant/ cheek 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 fs due and owing, and the applicant requests that a replacement

warrant/check be issued to him/her in the sum of $. 600.00 (3)

Signed: Af ee (4)

(5) Subscribed and yee me this iat day of Morombar 20r4,

NOTARY PUBLIC { t

JUDD $ BALESTRIER
. . Notary Pubtle
commission expires: State of Colorado
i " iD # 20234012483
J ‘ey r? \ 3.027 iy Gommtsston Expires 06-17-2027 (seal)

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

Warrant/Check Number [979984 0940

_ {if known) (6)

Original Date of Issue -
(gomn) (7) October 9, 2024

11/22/24

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

=) For Services or Goods furnished Future Hearts, Minds & Dreamers
Other: Future Hearts, Minds & Dreamers

S:\PROCESSES\Warsants - Duplicate or Stale\02 Forms\Schools\Schcois-Werrants Checks notice of cleim.doc
Revised June 2015 ARS, 11-632 & 15-999

Future Hearts, Minds & Dreamers

November 12th, 2024

To whom it may concern:

My name is Kytriena Payseno, and | am the owner of Future Hearts, Minds & Dreamers. |
have signing authority for the business Future Hearts, Minds & Dreamers. | am writing to
request a reissue of a check that was lost in the mail.

The check was #10940, and was payment for FHMD'’s Invoice #516.

Thank-you,
Kytriena Payseno

"I am enough of an artist to draw freely upon my imagination."
-Albert Einstein

SCHOOL EXPENSE WARRANT 3700810940)
TREASURER OF MARICOPA COUNTY pe of 00 810940
PHOENIX, ARIZONA ren DATE | CONTAOLNO. | |

THIS WARRANT DRAWS INTEREST FROM DATE MARKED “INSUFFICIENT FUNDS"

INTEREST STOPS ON DATE FUNDS AVAILABLE. (SEC 11-636, ARS1956)
10/08/2024 8850540 |
OSBORN ELEMENTARY SCHOOL DISTRICT #8 _ F
WARRANT AMOUNT G
PAY —_ —— —— | é
$600.00

“Six Hundred and 00/100** Dollars

VOID AFTER 365 DAYS

TO FUTURE HEARTS, MINDS & DREAMERS “GI \ \
THE . | y A} Lf OA tener
ORDER {
OF 3 F Steve Watsa:
= Superintendent o SPOR zen SIGNATURES
MARICOPA COUNTY SCHOOLS » PHOENIX, ARIZONA 10/08/2024 Check: 8850540 EXPENSE
AP 20241009 3700810940
FUTURE HEARTS, MINDS & DREAMERS | |_ 10/08/2024 _| |
— Payee | | Check Date | |
Account Number PO Number Invoice Amount

cor

VOUCHER: 7049 TOTAL: $600.00

HARLAND CLARKE 122692 40038910

Queued for positive pay:

Locked for reconcile:

Registered

Date registered:

No of days interest: 0
Annual interest rate: 0.00000

« Warrant Lines

o Amount Payee
600.00 FUTURE HEARTS, MINDS & DREAMERS

https://horizon.maricopa.gov/portal/webclient/#/desktop

11/14/24, 6:58 AM VMware Horizon
Warrant (1 - mcto) - Warrant number: 3700810940, Stopped
Warrant
ox ¥ 7, @
Warrant Status Print = Attachments
¥
Maintain New Status Setup Attachments
3700810940
4 Warrant header
General Posting
Warrant number: Invoice:
Holder: Invoice date:
Issued date: 10/8/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 10/9/2024 09:00:32 am
Exception flag:
Exception reason None

Agency voucher number: 7049
Agency claim number:

Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept num:

Account

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