STAMPED & REDACTED - FOR AGENDA ATTACHMENT - CHASE R BARNES.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

Isaac Dist. #5 Barnes, Chase R 3700810548 $1,073.47

Date

Amount.

Office of the Maricopa County
School Superintendent

District Name / Number: Isaac School

Contact Name: Heather Salazar

Finance Desk
mim 20291016

Warrant Void/Stop Request

District #5 Attachments:

[| Original Warrant

Contact — 60 tst~—~idC Lost Warrant Affidavit {required for ALL reissues)

C] Vendor Letter (if requesting Vendor reissue)

Warrant Number |} Warrant Date
[starting with “37°) baiin/del/yyyy)

Amount.°: _-- |.Payee:

_ |e it cxppears ih Check Manager)

Vold
Stop
Re-issve

3700810548) 10/8/2024

$1,073.47 | Chase R Barnes O®

©OU

©ou

©oUu

Notes: Lost Warrant, please reissue

District Approver: Hegther Salazar

Date: 19/18/2024

Reissue WT #.

For Internal Use Only

Clerk of Board Date:

Yoid 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.

Chase R Barnes

Name/Claimant

On or about 10/ 8/2024 (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
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.

(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 he issued to him/her in the sum of 41,073.47 (3)
2 os
signed: _( MH” LEE (4)

(5) Subscribed and sworn to before me this__ [4 day of bdleber 2027.

ROTARY PUBLIE PR CATHERINE ROMERO
Sage Notary Public - Arizona
My commission expires: Fi as z MARICOPA COUNTY

sy Commission # 638396

10/18/2024 eo” Expires Sopt. 24, 2026 (seal)

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

aie ine al 3700810548

Onittial Dols of al 10/08/2024

Reason for origina! issue of Warrant/Check (8):
= Payroll

0 For Services or Goods furnished
(J Other:

10/22/24

S;\PROCESSES\Warrants - Duplicate or Stale\Q2 Farms\Schools\s: : -
Revised June 2015

10/20/24, 11:09 AM

Warrant (1 - mcto) - Warrant number 3700810548, Stopped

Warrant |

VMware Horizon

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“a | Warrant Status | Print | Attachments

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Maintain j New \ Status | Setup | Attachments

3700810548
“aWarantheader ss a OC 7 —

General Posting

Warrant number: 3200810548 invoice:

Holder: Invoice date:
Issued date: 10/8/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 10/7/2024 09:00:01 arm
E tion flag: Hy
ron a9 Agency details
Except = Hy
ception ‘panos None Agency voucher number: 14
Queued for positive pay: jj Agency clairn number:
Agency low orig:
Locked forreconcile: | ! Agency PO number;
Registered Agency sub fund:
Date registered: Agency dept nur:
No of days interest: 0
Annual interest rate: 0.00000
4 Warrant Lines : -
Amount Payee Account

1,073.47 BARNES, CHASER

L
|
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|
|

la ad b> Pl | a | 3} | identification of the warrant

https://horizon.maricopa.gov/portal/webcilent/#/desktop

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