REDACTED - FOR AGENDA ATTACHMENT - ROHINI BADWAL.PDF

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

vV Phoenix, Arizona 85003
M A R) C oO PA C Oo U N T Y ; 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 Vw,
maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez
cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount Dept/School
No
ROHINI BADWAL 957594 $1,214.20 | Treasurer

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: O Duplicate or 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.
Ro Hint BaAbwaAL (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about _ S| 121 23 (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 $. $ }214- 2 loo (3)

Signed: Kibesn Badal 10] 25 ]o-44 (4)

Print name: (required) Rotini ADwAL

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

(5) Ye and sworn to before me this __2S“” day of ( he bec 2024.

NOPARY PUBLIC BD, shane someinoene
MARICOPA COUNTY
My commission expires: ae” Pano poly 2028
IM 06, 2O2E (Seal)
Warrant/Check Number
(if known) (6) id 4 s7s 44
Original Date of Issue
. (if known) (7) 5| | 23

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

O For Services or Goods furnished
[@ Treasurer's refund/payment PARCEL 303-46-099

O Other:
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

Yeriered
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Maricopa County Treasurer's Office 303-46-099 6 10/30/2024 11:01:09 AM
Fil 303-46-099 6 - x
File Help
Year | Description | ActDate | TranNum al Amount | Images [.PmtDate | Half Code | Act a
2024 TAX PAYMENT 2024-09-18 —072-11558 $1,131.54 N 2024-09-15 1 E34
2024 TAX BILL 2024-08-24 ¥ 12:(
2023. TAX PAYMENT 2024-02-21 053-38707 $1,108.39 N 2024-02-20 =F 6:3
2023. TAX PAYMENT 2023-09-19  050-28598 $1,108.39 Y 2023-09-18 1 6:4¢
2023 TAX BILL 2023-08-26 us 12:(
at REFUND te if 2:
2022 RES REFUND LETTER 2023-05-15 N 63°
2022 RES IMPOUND 2023-05-15 RS -02707 $1.214.20 N 63
2022. TAX PAYMENT 2023-05-15 AS -02707 $487.33 N 2022-12-31 F B32 ¥
< >
Parcel #: [303-46-099 Activity: REFUND Act Date:05/17/23
Tax Year: [2022 Tran#[- (| Act Time {12:00 AM

Activity Detail | Address Detail |

CP #: o
Buyer #: o
Fund: [26

Click icon for Disbursements Inquiry. ----->

Refund Amount: $1,214.20

Check Date: [05/17/23
Check #: | 957594

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View Image... |

Maricopa County Treasurer's Office Refund ID 2023008518 RESOLUTION
AM
& Refund ID 2023008518 RESOLUTION = oO x
File Help
&\&

Refund Amount: fst 214.20

- |
Requester: |RESOLUTIONS on 5/15/2023 |

Refund Reason: Resolution has reduced taxes

Status: [DISBURSED on 5/15/2023
Slip ID: {202300230

Address: [ROHINI BADWAL

Impounds | Stub | Comments |

| Source Fund | Linked | Amount | Tax Year | Statu
| 033 True $1214.20 2022 REAL
|
|
|

< >

Impound T otal: 1

Check Request: JRESO DESK
Refeience #: |RES #02707

! #1

Parcel/Roll -303-46-099 Dest fund : [026
CPH: fo Resott: [2707
CP buyer # Jo Phase #: [78

Mottgagecode: [|
Transaction #: [RS 02707
Case #: |

pot a ee ed

10/30/2024 11:02:02