STAMPED & REDACTED - FOR AGENDA ATTACHMENT - KAYDEN OPENSHAW.PDF
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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: 10/01/2024
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 Openshaw, Kayden 3700803554 $423.02
Date
Amount
Relssue WT #
Office of the Maricopa County
School Superintendent
Finance Desk
ram 20201016
Warrant Void/Stop Request
District Name / Number: QCUSD #95
Contact Name: Kathy Saxton
Attachments:
v Original Werrant
lv] Lost Warrant Affidavit (required for ALL reissues}
Vendor Letter (if requesting Vendor reissue)
Warrant Number
(starting with “37")
Warrant Date | Amount
(men/del/yyyy)
Payee
{es if appears in Check Manager}
Void
Stop
Re-issue
3700803554
9/17/2024 | $ 423.02
OPENSHAW, KAYDEN
Notes: Check drawn on/destroyed.
District Approver: tile
Date: 40/1/2024
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 Noto: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form,
OPENSHAW, KAYDEN
Neme/Claimant
On or about __ 99/17/2024 — (date)(2) a warrant/chack 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 $423.02 (3)
Signed: bebe a (4)
ee) I hg
(5) Subs rlbed anfi’sworn to before me this “30 day of Seplember 20.24.
/ ove |
NOTARY PUBLIC ees, sas ai
My commission expires: . Commission
eo Hon pages i Expres danunry 2, 200 | (seal)
Note; Please attach a copy of the warrant/check if avallable and/or any other
evidence that a warrant/check was originally issued,
TEE G (ef OUs03504. —
Orginal Date of Issue 19/17/2024 _)
Reason for original issue of Warrant/Check (8):
= Payroll
O For Services or Goods furnished
[J Other:
10/03/24
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools:
Revised June 2015
37
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Security porta ehs
10/1/24, 11:58 AM
| Warra nt |
heal Warrant | Status
Warrant (1 - mcto) - Warrant number: 3700803554, Stopped
VMware Horizon
+
Maintain New Status | Setup | Attachments
3700803554
“4 Warrant header 7
General Posting
Warrant number: 37008035 54) Invoices
Holder: Invoice date:
Issued date: 9/17/2024 Paid date:
Status: Stopped Positive pay sent date: 9/13/2024 09:00:13 arn
Excepti
meee ion flag | Agency details
xception reason: None Agency voucher number; 8
Queued for positive pay: | Agency claim number:
Agency tow orig:
Locked forreconcile: {| | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept nun
No of days interest: 0
Annual interest rat 0,00000
“a Warrant Lines : ~
(me Amount ; Payee i Account
423,02 OPENSHAW, KAYDEN
Iq > pr | | B) | tdentification of the warrant
htips:/fhorizon.maricopa.gov/porlal/webclienv#/desktop
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