STAMPED & REDACTED - FOR AGENDA ATTACHMENT - KELLY BRENNAN.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: 08/12/2024
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 Brennan, Kelly 3700782791 $431.19
Date
Amount
Reissue WT #
Office of the Maricopa County
School Superintendent
Watrant Void/Stop Request
Finance Desk
mm 20201016
District Name / Number: Queen Creek Unified School District #95 | atrachments:
Contact Name: Katherine Saxton
[| Original Warrant
Lost Warrant Affidavit {required for ALL reissues}
[] Vendor Letter (if requesting Vendor reissue)
Warrant Number Warrant Date | Amount Payee Zs a2 ©
[starting with “37") (mm/dd/yyyy) {as it appears in Check Manager} 2 2 2
3700782791) 7/23/2024 |$ 431.19 BRENNAN, KELLY OO
Cke]m
Notes: Check lost. Please re-issue.
District Approver: orb
Date: hy ey
For Internal Use Onty
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.
BRENNAN, KELLY (1), being first sworn, upon oath deposes and says:
Nameé/Craimant
On or about VA) 7 | Qal Boa} (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
LAY) M1 Rs sum of ¢431. 19 .(3)
aw, (4)
(5) = id sworn to before me this { ) ] day of HUAvs\ 202A.
NOTARY PUBLIC
CASSANDRA KENNEDY
Notary Public - State of Adzona
(i : atihicn ission # 629036
My eis dicy lp sks Commision 20088 ea)
seal
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
PINAL COUNTY
|
|
Warrant/Check Numb
arran i noun) (300782791
Original Date of Issue 07/23/2024
Reason for original issue of Warrant/Check (8):
Payroll
1 For Services or Goods furnished
C) Other:
8/13/24
S:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\Schools\S«
Revised June 2015
8/12/24, 7:52 AM
Warrant (1 - mcto) - Warrant number; 3700782791, Stopped
VMware Horizon
| Warrant |
rag Padel gy = t ‘ if 0 y
Ladi Warrant | Status | Print ; Attachments
r
Maintain New Status | Setup | Attachments
3700782791
4 Warrant header eee
General Posting
Warrant number: 3700782791) Invoice:
Halder: Invoice date:
Issued date; 7/23/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 7/19F2024 12:00:29 pr
& i qi
xception flag: {| Agency detatls
Exception reason: None
Agency voucher number 1
Queted for positive pay: | Agency claim number:
Agency low arig:
Locked forreconcile: [| 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
431.19 BRENNAN, KELLY SCs
Idd. > BL | | 8) | identification of the warrant
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