STAMPED & REDACTED - FOR AGENDA ATTACHMENT - SAVANNAH G SLATER.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: 10/21/2024

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 Slater, Savannah G 3700807830 $678.37

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

District Name / Number: QCUSD/95

Contact Name: Kathy Saxton

Finance Desk
mm. 20201016

Warrant Void/Stop Request

Attachments:
lv] Original Warrant
W| Lost Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue}

Warrant Number Warrant Date
{starting with “37") {mmn/de/yyyy)

Amount

Payee

{es it appears in Check Manager}

Void
Stop

3700807830 10/1/2024

$ 678.37

SLATER, SAVANNAH G OO

Notes: bottom of check damaged

District Approver: Goobn

Date: (oli 7/e4

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 sheat which is page 2 of this form.

SLATER, SAVANNAH G

Name/Claimant

On or about _|OL{ labay (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.

(1), being first sworn, upon oath deposes and says:

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 $ 678.37 (3)

Signed: Senso wrrlt, OQekee, (4)

(5) Subscribed and sworn to before me this (7 day of Octover 20 oA.

NOTARY PUBLIC

CASSANDRA KENNEDY
Notary Pubte - State of Arizona
PINAL COUNTY.
Commission #629036

My commis: ires: y
AL AORN - (seal)

Explos May 8, 2028

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

[ Warrant/Check Numb

Original Date of Issue 10/1/2024

(if known) (7) _

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

( For Services or Goods furnished
O Other:

10/22/24

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

“ SCHOOL'EXPENSE WARRANT:

TREASURER OF MARICOPA COUNTY,

THIS WARRANT DRAWS INTEREST FROM PATE MARKED "INSU! FRCIENT FUNDS”
INTEFIEST STOPS ON BATE FUNDS AVAILABLE, (SEC. 41-630, ARS1055)

Queen Creek Unified District #95 VW ,
pay OID

**S}x Hundred Seventy Elght and 37/100*** Dollars
Community Ed

SLATER, SAVANNAH G

TO
ORDER C)
% i

OF

PHOENIX, ARIZONA —_ gi-pieat *

DATE

CONTROL NO,

10/01/2024

95727166

WARRANT AMOUNT

$678.37

4m Volb AFTER 365 DAYS”

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10/20/24, 11:06 AM

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Status

VMware Horizon

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i Warrant Print | Attachments
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Maintain | New \ Status | Setup | Attachments
3700807830
“aWarantheader
General Posting
Warrant number: 370080783) Invoice:
Halder: Invoice date:
Issued date: 10/1/2024 12:00:00 ann Paid date:
Status: Stopped Positive pay sent date: 9/27/2024 09:00:06 am
nen flag: Ld Agency details
ception reason: None Agency voucher number: 9
Queued for positive payt b'} Agency claim number
, Agency law orig:
Locked forreconciler | | Agency 20 number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000
| Warrant Lines ~ ne ne
O Amount Payee Account

678.37 SLATER, SAVANNAH G

Pee a

hitps://horizon,maricopa.gov/portalfwebclient/#/desktop

PY} | Identification of the warrant

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