STAMPED & REDACTED - FOR AGENDA ATTACHMENT - REYNA RICKS.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: 10/10/2024

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

Queen Creek Dist #95 Ricks, Reyna 3700803560 $212.79

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent sca 20203016

Warrant Void/Stop Request

District Nome / Number: Queen Creek Unified School District #95 [anachments

Contact Name: Kathy Saxton Original Warrant

Contact e-mail: rT Lest Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue)

Werrant Number Warrant Date | Amount Payee z= 2 @
{starting with “37~) (mm/dd/yyyy) {as it appears in Check Manager} 2 é z

Ea
3700803560! 9/17/2024 | $ 212.79 RICKS, REYNA

Notes: Employee never recieved check.

District Approver: po Si tp A Date: {6 | G [ee nt

For Internal Use Only

Clerk of Board Date: Void Report Date:

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.

RICKS, REYNA (1), being first sworn, upon oath deposes and says:
Name/Clalmant

On or about 4 li aA (date)(2) a warrant/check was Issued to the

above named person/dntity ‘in the amount as stated below. Such warrant/check was
either never received or was subsequently inadvertently lost or destroyed and there is
ho 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 $212.79 (3)
Signed: Fotos Frc Me® (4)

(5) Subscribed and sworn to before me this Y day of October 20A4-

‘_—_———

NOTARY PUBLIC

CASSANDRA KENNEDY
Notary Ptiblio - Stale of Arizona
PINAL COUNTY
Commission # 529036
Expies May 8, 2023

" POE 0 : al

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

W Check Numb
errant check 6 a 3700803560

Original Date of aue 09/17/2024

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

0 For Services or Goods furnished
{) Other:

10/15/24

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schc
Revised June 2015

10/10/24, 8:04 AM
Warrant (1 - mcto) - Warrant number: 3700803560, Stopped

BA | Warrant | .

VMware Horizon

PR Ue leis } ) >
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Warrant | Status | Print | Attachments
Maintain New Status | Setup | Attachments
3700803560
“a Warrantheader 7 oo
General Posting
Warrant number: 3700803560) invoice:
Holder; invoice date:
Issued date: 9/97/2024 12:00:00 am Paid cate:
Status: Stopped Positive pay sent date: 9/13/2024 09:00:13 am
Exception flag: il Agency details
Exception reason: None Agency voucher number. 8
Queued for positive pay: | Agency claim number:
Agency low orig:
Locked for reconciles || Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00090
4 Warrant Lines | ee
C Amount Payee Account

212.79 RICKS, REYNA

Idd ® bl] | } | identification of the warrant

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