STAMPED & REDACTED - FOR AGENDA ATTACHMENT - ASHLEY PAIGE MASINDET.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: 09/17/2024

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

Litchfield Dist #79 Ashley Paige Masindet 3700792142 $336.62

Office of the Maricopa County
School Superintendent Warrant Void/Stop Request

sta toe moe cba Elem SOrush Dstt Term

[| Original Warrant

Contact Name: Naat 2 th infinite Visions Void Report
Contact e-mail: Lost Warrant Affidavit (if requesting reissue)

Vendor Letter (if requesting reissue for a company)

Warrant Number Warrant Date Amount Payee
(starting with “377) {mm/dd/yyyy) [as it ppears in Check Menager}

70014214 Z| Olisiad $3do-02) Niasindtk, Ash Paige

Check here if requesting MCSS reissue the warrant: |

Notes:

oct approver NOLMED Sep nae Allo (D014

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.

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

On or about Hla 44 (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/c eck be iss' sum of $ BAlo : lo Z (3)

Signed: (4)

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v

(5) Subscyibed and sworn to before me this G Y day of Xoktmbee: 20 14.

My commission expires:

(seal)

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

Original Date of Issue
(if known) (7)

verona [ZOO TT LYE
OUD

Payroll
C1 For Services or Goods furnished
O Other:

4 for original issue of Warrant/Check (8):

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

9/13/24, 7:36 AM

Warrant (1 - mcto) - Warrant number: 3700792142, Stopped

i i\ Warrant
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#

bait Warrant | Status | Print | Attachments

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Maintain New
3700792142

“a Warrant header

General

Warrant number:
Holder:

issued date: 8/13/2024
Status: Stopped
Exception flag: a)
Exception reason: None

Queued for positive pay: |]

Locked forreconcile: =| i
Registered

Date registered:

No of days interest: 0
Annual interest rate: 0.00000

Status | Setup | Attachments

12:00:00 am

VMware Horizon

Posting

Invoice:

Invoice cate:

Paid date:

Positive pay sent date:

8/12/2024 09:00;24 am

Agency details

Agency voucher number 3
Agency claim number,
Agency low orig:

Agency PO number:
Agency sub fund:

Agency dept num:

4 Warrant Lines

Ly Amount ; Payee
336.62 Masindet, Ashley Paige

» Account

hitps://horizon.maricopa.gov/perlal/webciient/#f/desktop

| Yj | Identification of the warrant

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