REDACTED - FOR AGENDA ATTACHMENT - BONNIE PAULSON.PDF

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003

l
M A R) C Oo PA C Oo U iby TY __ Phone: (602) 506-8511

TREASURER’S OFFICE

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer’s Office
Maria Quitangon WW
maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez (>
cathy.sanchez@mari€opa.gov
602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No
BONNIE PAULSON 957298 $397.20 | Treasurer

Application for a Duplicate or Stale-Dated Warrant/Check

Affidavit/Claim Form ci

This application is for: Oo Duplicate or B® stale-Dated (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.
“Bonn: rd LA | son (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about one 2023 (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 issued to_him/her in the sum of $_ 397 Ze (3)
Signed: Lie — (4)

Print name: (required) Bonni eu ls on

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_O< day of Novembe 2024.
< NOTARY PUBLIC

KIMBERLEY G, SHADY
Notary Public - State of Arizona
MARICOPA COUNTY
Commission # 657366
Expires October 01, 2027 (seal)

My commission expires:
10-0127

Warrant/Check Number =
(if known) (6) 957 29L

Original Date of Issue BS
(if known) (7) S/, Z of; 23

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

0 For Services or Goods furnished

J Treasurer's refund/payment

& Other: awe ele vet
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 A.R,S. 11-632 & 11-644

JEWELED
leached

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Maricopa County Treasurer's Office 984-13-731 6 11/20/2024 8:10:56 AM

PBB 904-13-731 6 - x

File Help
Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act A
2024 = TAX PAYMENT 2024-10-10 = 071-90848 $413.69 N 2024-10-07 = 1 6:3
2024 =TAXBILL 2024-08-24 Y 12:(
2023. TAX PAYMENT 2024-04-25 = 0771-32351 $815.62 N 2024-04-22 F 7:08
2023. RES FULL YEAR DUE LETTER 2024-04-04 N 6:3
2023 =POSTNEWTAX(RESOLUTION) 2024-04-04 AS -04657 $815.62 N 6:38
2023. CANCEL TAX 2024-04-04 RS -4657 $1,060.08 N 6:3E
2023. RESOLUTION REPRINT 2024-04-04 a 12:
2023 TAX BILL 2023-08-26 ns 12:

<

REFUND 5-10

< >
Parcel #: e841 3-731 Activity: IREFUND Act Date}05/10/23
Tax Year [0 Tran # [- i | Act Time {12:00 AM

| cP# fot~—‘“—:~CS~™S Check Date: [05/10/23
| Byer [T  — Check #: [957298
| Fund: fe © Refund Amount: J $397.20

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Maricopa County Treasurer's Office

Refund ID 2023008076 MANUAL

&. Refund ID 2023008076 MANUAL
File Help

S123)

| Refund Amount: fsas7. 20

Requester |JOSE.MANCERA on 5/8/2023

| Refund Reason: [Refund being made at payer's request

Status: JDISBURSED on 5/8/2023
Slip ID: [202300215

Address:

Impounds | Stub | Comments |

Check Request )JOSE
Reference #: [-

Source Fund | Linked |

Amount | Tax Year | Status

094 True $397.20 0

|
| Impound Total: 1
|

Impound #1
Paicel/Rell [98413731 Dest fund: [026
—_ CP#: fo Resot: [0
CPbhwert:[0 Phase#: [0
Mottgagecode: [
> Transaction#: [0si97si2,0
Case #: | |

11/20/2024 8:11:47 AM