STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MARRISSA WILSON.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: 08/19/2024

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

Littleton Dist #65 Wilson, Marrissa J 3700712773 $1,271.56

scrotoiae © [San Sa man 7 MCESA Stop/Cancel/Void Form

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StopCancelReleaseForm pdf ated Approved By: Z Date: iF Z

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11/14/11

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,
ya nh Soa Te hiker (1), being first sworn, upon oath.deposes and says:

On or about yvttietr Bf, 22D (date)(2) a warrant/check was Issued to the
above named person/entity In the amount as stated below. Such warrant/check was
elther 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 $__“77/. 5 Ce (3)

~~
Signed: VW aula, LA @; yA) (4)

ry

LA

(5) Subscribed and sworn to before me this

NOTARY PUBLIC y

» _MARIAD, KRIEGER
My commission expires: __ inca Nay Pit St laters
pee iL cn A (ay) i 22 2 A Commission ¢ aoeers
w ‘ 5 Expires February 01, 2025

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

Warrant/Check Number 27790; AS Z 73

(if known) (6)

Original Date of Issue
9 (If known) (7) Yowrnber 32f POR?

Reasgn for original Issue of Warrant/Check (8):
i Payroll

\

D For Services or Goods furnished
O Other:
8/19/24

S:\PROCESSES\Werrants - Duplicate or Stale\02 Forms\Schools\Schools-'
Revised June 2015

8/19/24, 9:47 AM VMware Horizon
Warrant (4 - mecto) - Warrant number: 3700712773, Stopped

Warrant |
fv thle i jk fi a |
t=] |e) To] |
hail Warrant | Status | Print | Attachments
’ i
3700712773
4 Warrant header . : eee —
General Posting
Warrant number: 3700712713 Invoice:
Holder: invoice date:
Issued cate: 19/21/2023 12;00:00 am Paid date:
Status: Stopped Positive pay sent date: 11/16/2023 09:00:21 am
Exception flag: [3 Agency details
E ti son:
XEEpHON reason None Agency voucher number: 16
Queuied for positive pays || Agency claim number:
. Agency low orig:
Locked forrecanciles [| Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of days interest; 0
Annual interest rate: 0,00000
oO Amount : Payee Account

Iq ado. & Pl | ee | nH | Identification of the warrant

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