STAMPED & REDACTED - FOR AGENDA ATTACHMENT - TYLER J WHITE.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

Riverside Dist. #5 White, Tyler J 3700788988 $210.00

Office of the Maricopa County Finance Desk

School Superintendent mm 20201036

Warrant Void/Stop Request

District Name / Number: Riverside School District #2 Attachments:
Contact Name: Teresa Solares Original Warrant
Contact e-mail: po WA Lost Warrant Affidavit (required for ALL reissues)
Vendor Letter (if requesting Vendor reissue)
$ Warrant Number Warrant Date | Amount Payee 3 Qe
a (starting with “37") (mm/dd/yyyy) (as it appears in Check Manager) 2 3 z
2
3700788988 | 8/2/2024 $ 210.00 TYLER J WHITE 0 OV
=
3
£
<<

Notes: Warrant is lost. Please stop payment and reissue.

For Internal Use Only

Clerk of Board Date: Void Report Date:

Reissue WT #

s

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (uetnitions 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.
TYLER J WHITE

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

On or about August 2, 2024 (date)(2) a warrant/check was Issued to the
above named person/entity In the amount as stated below, Such warrant/check was
elther 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 tn the sum of g 210.00 (3)

—
Signed: — Tyla wll Ne (4)

(5) Subscribed and sworn to before me this, ({  dayof_O,tuber 2024.
NOTARY PUBLIC vuve
GU, CLAUDIA VILLARREAL
My commission expires: 4) Sommislaa No, 209087168"
’ Bay) = My Commission Expires (seal)
_Jonuaty 9, 2026

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 Number 3700788988

(if known) {6)

Original Date of Issue
(if known) (7) 8/2/2024

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

For Services or Goods furnished traffic control services
CO Other; Traffic control services

Ss\PROCESSES\Warrants - Duplicate or Stale\02 Forms\$chools\Schools-Warrants ( 10/22/24
Revised June 2015 4

Brasio Pee

_sroarepeee

“SCHOOL, EXPENSE WARRANT: x

Fe PROEND Art OF MARICOPA COUNTY; a Spot:
inveneae Nope ON DATE FUNDS AVAILABLE, (SEC 11-635, ARS1956) t

08/02/2024 2060265
Riverside Elementary District #2 Ps
WARRANT AMOUNT
PAY
“Two Hundred Ten and 00/100" Dollars $210.00

WHITE, TYLER J.

VOID AFTER 385 DAYS
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. 08/02/2024 Check: 2060265 EXPENSE
MARICOPA COUNTY SCHOOLS + PHOENIX, ARIZONA AP 20240808 — a7oo7senae
_WHITE. TYLER J. | |_ vavoz/2024
Payee | | Check Date
AccountNumber PONumber {nvoice Amount
| Wee Tee30 210.03

YOUCHER: 009 TOTAL! $210.00

HARLAND CLARKE 1422692 30106562

10/20/24, 9:59 AM
a] Warrant (1 - mcto) - Warrant number: 3700788988, Stopped
| a| Warrant |

VMware Horizon

FR bette pH Os
|e Td |
Warrant | Status | Print | Attachments |
tow
i |
Maintain New | Status | Setup | | Attachments |
3700788988
a Warrant header —_
General Pasting
Warrant number TOD 7S89R8) Invoice:
Holder: Inveice date:
Issued date: 8/2/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent datet 8/5/2024 09:00:22 arm
Exception flag: m Agency details
Exception reason: None

Queued for positive pay: |.|

Locked forreconciles | |
Registered

Date registered:

No of days interest: 0
0.00000

Annual interest rate:
4 Warrant Lines

ig Amount Payee
| .
| 210,00 WHITE, TYLER J,

‘44 bm pt]

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Agency voucher number: 1009
Agency claim number:

Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept num:

Account

* | ia) "| identification of the warrant

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