REDACTED - FOR AGENDA ATTACHMENT - SPECIAL SOLUTIONS INC #955799.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 ye
maria.quitangon@maricopa.gov
602-506-1958
Cathy Sanchez 097
cathy.sanchez@maricopa.gov
602-506-7881
Re: Stale Dated Warrant
Name
Warrant
No
Amount
Dept/School
SPECIAL SOLUTIONS INC
955799
$140.17
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 March 31, 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 $ 140.17 .(3)
Signed: _Waha Lynn Lewis (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.
(5) Subscribed and sworn to before me this _'4th day of __ August 20_24 .
Evrard lism wry ECHARD BIEN-AIME
NOTARY PUBLIC Notary Public - State of Florida
Et Commission # HH 153738
py rs . | Pros Expires on July 14, 2025
My commission expires: yer
(seat)
otarized remotely Online using communication technology via Proof.
Warrant/Check Number
(if known) (6) 955799
Original Date of Issue
one frown) 0 March 31, 2023
Reason for original issue of Warrant/Check (8):
O Payroll
O For Services or Goods furnished
§§ Treasurer’s refund/payment
= Other; Redemption of Certificates of Purchase #21016874 and 21016630
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
VECIEIEY
Me
Flailey
Maricopa County Treasurer’s Office
ATTN: Maria Quitangon
301 W Jefferson St
Phoenix, AZ 85003
O: 602-506-1958
Date: 8/14/2024
To Whom It May Concern:
RECEIVED
AUG 20 2024
MARICOPA County
TREASURER
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
Kara L. Lewis
President, Special Solutions Inc.
Maricopa County Treasurer's Office 504-54-050 4 8/21/2024 10:22:13 AM
PBB 504-54-050 4 - x
File Help
Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act’ A
2023 =DELINQUENT NOTICE 2024-06-03 Y 12:0
2023 TAX BILL 2023-08-26 ha 12:0
ee 20 $51.07. N 120
2021 REDEMPTION PAYMENT 2023-03-15 071-91142 $61.07 N 2023-03-10 6:32
2022. TAX PAYMENT 2023-03-15 0071-91142 $27.00 N 2023-03-10 1 6:32
2021 CPBUYER PAYMENT 2023-02-15 087-00049 $55.90 N 2023-02-15 F 7:46
2021 =DELINQUENT NOTICE 2022-11-28 Y 12:0
2022 TAX BILL 2022-08-20 5 12:0
2021 = DELINQUENT NOTICE 2022-06-02 Y 120
< z
Parcel #: (504-54-050 Activity: REFUND Act Date:03/31/23
Tax Year: [2021 Tran #:[- fe Act Timef12:00 AM
Activity Detail | Address Detail |
cP fioTe874
Buyer#: [9385 °—~—~—~OCS
Fund 60S
Click icon for Disbursements Inquiry. ---->
Check Date: 03731 /23
Check #: [ar
Refund Amount: [ $51.07
View Image...
Close
002
TeoTAL
002
51 °O7%+
89+*10+
140+17x*+
Maricopa County Treasurer's Office 504-15-541 2 8/21/2024 10:23:12 AM
FRB 504-15-541 2 = x
File Help
Year | Description | Act Date taal | Tran Num | Amount | Images | Pmt Date | Half Code | Act Tia
2023. =DELINQUENT NOTICE 2024-06-03 ¥ 00:
2023 TAX BILL 2023-08-26 Y:
REFUND 31 $ 0
2021 REDEMPTION PAYMENT 2023-03-15 072-77750 $99.10 N 2023-03-11 6:31:0
2022 TAX PAYMENT 2023-03-15 072-77749 $3,077.95 N 2023-03-11 F 6:31:0
2021 CP BUYER PAYMENT 2023-02-15 087-00049 $94.03 N 2023-02-15 7:46:0
2021 = DELINQUENT NOTICE 2022-11-28 ae 12:00:
2022 TAX BILL 2022-08-20 ¥; 12:00;
2021 DELINQUENT NOTICE 2022-06-02 ¥ 12:00: v
< >
rr ae Serer Sarre ae SELVES as z
Parcel #: 504-1 5-541 Activity: JREFUND Act Date|03/31/23
Tax Year: [2021 Tran #:[- isi Act Time {1200 AM
Activity Detail | Address Detail |
CP #: [21016630 Check Date: [03/31/23
Buyer: Check [TT
Fund: 50 Refund Amount: 0
Click icon for Disbursements Inquiry. ---->
|
Le
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Maricopa County Treasurer's Office
Refund ID 2023004281 CP_BUYER
& Refund ID 2023004281 CP_BUYER
File Help
Caley
Requester: JECHECKWEB on 3/15/2023
Refund Reason: |cPR edemption refund
Address:
Impounds | Stub | Comments |
Status: [DISBURSED on 3/31/2023
Slip 1D: [202300165
Check Request: [MAIL
Reference #: [CP 21016874
Impound #1
Source Fund | Linked |
Amount | Tax Year | Status
Parcel/Roll :|504-54-050 Dest fund : 050
050 True $51.07 2021
READ*
CP H: 21016874 Reso #: fo
CP buyer #:/9385 Phase #: [0
Mortgagecode: [
07191142
> Transaction # :
Impound Total : 1
————
Case #:
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8/21/2024 10:20:31 AM
Maricopa County Treasurer's Office Refund ID 2023004267 CP_BUYER
&, Refund ID 2023004267 CP_BUYER = Oo
File Help
Ee
Refund Amount _fseat0
Requester: |CCARDWEB on 3/15/2023
Refund Reason: [cr Redemption refund Status: [DISBURSED on 170003
| Slip ID: [202300165
Address: Check Request: [MAIL
Reference #: |cP 21016630
Tee a)
Impounds | Stub | Comments |
| 3 Impound #1
Source Fund | Linked | Amount | Tax Year | Status Parcel/Roll [5041 554 Dest fund : [oso
050 True $89.10 2021 READ‘ cPH: 21016630 Reset: jc
CP buyer #:[9385. Phase # : co
Mortgagecode: [
< > Transaction # : jov777500—C*~*
Impound Total : 1 Case #:
8/21/2024 10:18:18 AM