STAMPED & REDACTED - FPOR AGENDA ATTACHMENT - UNITED EDUCATION INSTITUTE.PDF

v
MAR) COPA
COUNTY

Office of Budget & Finance
301 W. Jefferson St., 9* Floor
Phoenix, Arizona 85003

P: 602-506-3561
F: 602-506-4451

Maricopa.gov

To: Clerk of the Board

From: Office of Budget & Finance, Accounts Payable
Date: 8-6-2024

Subject: Affidavit — Replacement of Lost Warrant

Please find attached one Affidavit for a lost warrant to be included on the next
available Board Agenda.

* The attached item has been researched to ensure the warrant in question has not
been cashed or previously re-issued.

e The original warrant is presumed lost.

Please call Walter Chang at 506-8747 if you have any questions. Please return the
approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor.

Thank you.

Re: Fund : 222 / D220 - / United Education Institute

Application for a Duplicate or Stale-Dated Warrant/Check

Affidavit/ Claim Form

This application is for: Duplicate or CL stale-Dated (definitions are on page 2)

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

UNITED EDUCATION INSTITUTE ; ;

— (1), being first sworn, upon oath deposes and says:
On or about 29-Mar-0224 (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 $2,605.00 (3)
Signed: Ap»Aaudh Graf (4)

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 5th day of AUGUST 20 2Y ;
KRISTELY ANN Sav misve

NOTARY PUBLIC Soda: KRISTELY ANN. SAN) MIGUEL i Ren
2 Notary: Pubitc + California : wey
5. Fe . Se Commission'# 2407415 x
My commission expires: SSE" My Comm. Expires Jum 6, 2026 "

06/06 P02

Warrant/Check Number 3010178132

(if known) (6)

Original Date of Issue
dia ted 29-Mar-0224

Reason for original issue of Warrant/Check (8):

O Payroll
For Services or Goods furnished_/ MOZELL PARKER OST1 AD /

OO Treasurer's refund/payment
Other: / check presumed lost/ fund: 222 , initiated by the vendor

di INTERNATIONAL EDUCATION
= CORPORATION

International Education Corporation

August 5, 2024

Maricopa County Office of Budget and Finance
Attn: Accounts Payable

301 W. Jefferson Street, 9th Floor

Phoenix, AZ 85003

To Whom It May Concern:

|, Darcy Schnuth, authorize Firdaus Yusuf, Senior Education Partnership Specialist, to
execute an affidavit on behalf of International Education Corporation.

Yo ¥ truly,

fp

Darcy Schnuth ~
Vice President of Student Finance & Records Management