STAMPED & REDACTED - FOR AGENDA ATTACHMENT - TARA VANESSA BENT.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: 09/03/2024

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

Fowler Dist #45 Bent, Tara Vanessa 3700793931 $1,841.53

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

Warrant Void/Stop Request
District Name / Number: FOWLER ELEMENTARY SCHOOL DIS’ | attachments:

Contact Name: YVETTE ORTIZ

Finance

mim 20201016

Desk

Original Warrant

UW | Lost Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee weenie Mase
(starting with "37") {mm/dd/yyyy) (as it appears in Check Manager) 2 FS 3

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3700793931) 8/20/2024 | $ 1,841.53 BENT, TARA VANESSA ONO} Z

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Notes: THE POST OFFICE LOST THE EMPLOYEE'S WARRANT

District Approver: YWETTE ORTIZ

Date: 8/98/2024

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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 Note: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.

BENT, TARA VANESSA (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 8/20/2024 (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
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 ¢1841 93 (3)

signed: 1 «| (4)
(5) Subscribed and sworn to before me this 22, day of _Puqust _ 20 Zy :

yralce oz
NOTARY PUBLIC "OS

Mv commission expires:

ne Ane Dey (S)

(e337) Js} Maricopa County, Arizona
OJ My Comm. Expires 08-06-26
Commission No. 635913

(seal)

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

Meron pene” _ (3700793931
Original Date of Issue 08/20/2024

Reason for original issue of Warrant/Check (8):
@ Payroll
QO) For Services or Goods furnished
O Other:

9/4/24

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

9/3/24, 8:54 AM
Warrant (1 - mcto) - Warrant number: 3700793931, Stopped

VMware Horizon

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Warrant Status Print Attachments
Maintain New Status Setup Attachments
3700793931
4 Warrant header
General Posting
Warrant number: 3700793931 Invoice:
Holder; Invoice date:
Issued date: 8/20/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 8/16/2024 09:00:11 am
Exception flag: Agency details
Exception reason: None Agency voucher number: 7
Queued for positive pay: Agency claim number:
Agency low orig:
Locked for reconcile: Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000
4 Warrant Lines — :
oO Amount Payee Account
1981.5. BENT, TARA VANESSA es
ld < > pi | ‘ é | } | Identification of the warrant

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