STAMPED & REDACTED - FOR AGENDA ATTACHMENT - CHARLENE BELLAMY.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: 08/19/2024 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 Bellamy, Charlene 3700785998 $1,835.55 Schootbistict "| Le ” Lh hen =. MCESA Stop/Cancel/Void Form . 3 Education. Service Attachments: } Original Warrant District # |. LOS vo Agen ae Voucher Number Af tS one ; Fund Cee MICR Number ; Amount Warrant Date System Generated Warrant # Payee ee LALOR Fe | “3 256S- | [7afod_] [. BILLA EEO | \LBetlitic: DA ZZ — Lo i | im Te : [| aa | TC TI i [) fd EE _ a ——= : Lo | ak | | IL al iz _ SS ee ee Reason for Stop, Cancel or Void: Ty check here if to be reissued by MCESA CV AN i — ~T — ——— | ow [Spy ; + . i ~ Approved By: — | yo StopCancelReleaseF orm pdf aled pprovedi By: f(s | Date: S419 11/14/11 Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (definitions are on page 2) D STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the NTY OF MARICOPA Instruction sheet which Is page 2 of this form. o9 a y Mele Lb Lo rues, being first sworn, upon oath.deposes and says: On or about hy ZL 22 (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, clalmant hereby affirms that this clalm Is correct and the amount shown Is due and owing, and the applicant requests that a replacement warrant/ch Ck 7 to him/her Jp the sum of i, 35 (3) Signed: (4) (5) Subscribed and sworn to sworn to before me this / 31) day of Aul Laut wed J Yawn) | A ters } NOTARY PUBLIC ov MARIA D: KRIEGER Notary Public - State of Arizona Is} MARICOPA COUNTY <’: Commission # §97913 Expires February 01, 2026. My commission expires: Pe bined. op, 2025 Note, Piegse attach a copy of the warrant/check | If available and/or any other evidence that a warrant/check was originally issued, Warrant/Check Number a ey = Sogn SID OUVES IFS Original Date of Issue 3 , ane hows) July If) 202 Reason for original Issue of Warrant/Check (8): Payroll O For Services or Goods furnlshed___ ) Other: 8/19/24 S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\$ct Revised June 2015 8/19/24, 9:48 AM Warrant (1 - mcto} - Warrant number: 3700785998, Stopped | Warrant | Va feta VMware Horizon iad Warrant | Status | Print | Attachments __.Maintsin |New _ | Status | Setup | Attachments 3700785998 4 Warrant header General Warrant number: 3700785998) Holder: Issued date: 7/31/2024 12:00:00 am Status: Stopped Exception flag: | Exception reason: None Queuedl for positive pay: kt Locked forreconcile; | | Registered Date registered: No of days interest: 0 0.00000 Annual interest rate: Pasting Invoice: Invoice cate: Paid date: Positive pay sent date: 7/29/2024 Agency details Agency voucher number 4 Agency claim number: Agency low orign Agency PO number: Agency sub fund: Agency dept num: 09:00:30 am 4 Warrant Lines oO Amount | Payee 1,835.55 BELLAMY, CHARLENE hitps://horizon.maricopa.gov/portalAvebcllenv/#/desktop i bl | “ | 8) | Identification of the warrant Ww