REDACTED - FOR AGENDA ATTACHMENT- SPECIAL SOLUTIONS INC.PDF

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MARICOPA COUNTY

TREASURER’S OFFICE

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100

Phoenix, Arizona 85003
Phone: (602) 506-8511
Fax: (602) 506-1102

http://treasurer.maricopa.gov

To:

Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer’s Office

Maria Quitangon We

maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez CFD

cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name

Warrant
No

Amount

Dept/School

SPECIAL SOLUTIONS INC

956744

$26.68

Treasurer

Application for a Duplicate or Stale-Dated Warrant/Check

Affidavit/Claim Form

This application is for: O Duplicate or fal Stale-Dated (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.
Kara L. Lewis (1), being first sworn, upon oath deposes and says:
Name/Claimant .
On or about April 28, 2023 (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/check be issued to him/her in the sum of $26.68 (3)

Signed: (4)

Print name: (required) Kara L. Lewis

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

Tr Texas
(5) Subscribed and sworn to before me this _'6th day of __ September 20 24

(le xthepael, Palursa Shepard fe Palursa Shepard
fe th a
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NOTARY PUBLIC 1eg Oak a 4> 1D NUMBER

134095343

Notary Public, State of Texas ed Nf Cohibinesion meinay
maa December 7, 2026
My commission expires: Electronically signed and notarized online using the Proof platform,
12/07/20
(seal)
Warrant/Check Number
(if. known) (6) 956744

Original Date of Issue ‘
re aie April 28, 2023

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

O For Services or Goods furnished

x Treasurer’s refund/payment
lm Other; Redemption of Certificate of Purchase #21015832

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 A.R.S. 11-632 & 11-644

VERA ey
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yo

Maricopa County Treasurer’s Office
ATTN: Maria Quitangon

301 W Jefferson St

Phoenix, AZ 85003

O: 602-506-1958

Date: 9/16/2024

To Whom It May Concern:

Please process the attached Affidavit for Stale-Dated Check. The stale-dated check was caused by
moving from Maryland to Virginia and transitioning mailing addresses between both locations. As a
result, some mail was not properly or timely forwarded to the new mailing address.

The current mailing address is

Thanks,
Ly ‘

President, Special Solutions Inc.

Kara L. Lewis

Maricopa County Treasurer's Office 501-85-187 7 10/7/2024 8:39:35 AM
EB 501-285-187 7 - x
File Help
Year | Description _ | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act A
2024 = TAX BILL 2024-08-24 ¥ 12:0
2023. TAX PAYMENT 2023-12-20 0652-93278 $403.00 Y 2023-12-19 F 6:33
2023. TAX BILL 20: ¥ 12:0
REFUND d i N oF
2021 REDEMPTION PAYMENT 2023-04-13 470-05055 $36.68 N 2023-04-13 10:5
2021. + CPBUYER PAYMENT 2023-02-15  087-00049 $31.11 N 2023-02-15 7:46
2021 =DELINQUENT NOTICE 2022-11-28 Y 12:0
2022. TAX PAYMENT 2022-11-03 411-22874 $403.52 N 2022-11-03 F 2:06
2022 TAXBILL 2022-08-20 Y 120¥
= | i >
Parcel #: [501-85-187 Activity: REFUND Act Date:|04/28/23
Tax Year: [2021 Tran #:[-- ah Act Time {12:00 AM

Activity Detail | Address Detail |

| CP #: 77] 015832
Buyer #: [9385
| | Fund: {50

| Click icon for Disbursements Inquiry.

Check Date: [04/28/23
Check #: [956744
Refund Amount: | $26.68

View Image...

Maricopa County Treasurer's Office

Refund ID 2023006406 CP_BUYER

& Refund ID 2023006406 CP_BUYER
File Help

Caky } |

Print Refund Ry ry
moun e [s26.68

Refund Reason: \cP Redemption refund

Requester, [EVELYN.ELLIS on 4/13/2023
Status. [DISBURSED on 4/28/2023
Slip 1D; [202300199

Address: SPECIAL SOLUTIONS INC

|
Impounds | Stub | Comments |

Source Fund | Linked | Amount | Tax Year | Status
050 True $26.68 2021 READ
< te >

Impound Total: 1

Check Request: [MAIL
Reference #: cr 21015832

Impound #1
Patcel/Roll :}501-85:187 Dest fund : ]050
CP#: 21015832 Reso #: fo

CP buyer # :[9385 Phase #: [0
Mortgage code:

Transaction #:  |47005055
Case #: J

|
Sree. SS eek aes Bee
|

10/7/2024 8:40:59 AM