REDACTED - FOR AGENDA ATTACHMENT - STATE FARM MUTUAL AUTO INSURANCE CO.PDF

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003

v
MA R) COPA COUNTY pax (602) S06-1102

TREASURER’S OFFICE http://treasurer.maricopa.gov

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer’s Office

Maria Quitangon
maria.quitangon@maricopa.gov ~~
602-506-1958

Cathy Sanchez
cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount Dept/School
No
STATE FARM MUTUAL AUTO 954151 $2,387.42 | Treasurer

INSURANCE CO

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form

This application is for: O Duplicate or 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.

State Farm Mutual Insurance Co (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 1/19/2023 (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 bg issued to him/her in the sum of $2,387.42 .(3)
Signed: end. Sd (4)

Print name: (required) Amanda Guyer

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 ot day of Sune, 20.24.

NOTARY PYBLIC J
OFFICIAL SEAL
a . CODY M HAYES
My commission expires: Notary Pub, Sa of His
10/14/ BoaT My Commission Expires October 13, 2027 (seal)
Warrant/Check Number
(if known) (6) 954 1 5 1

Original Date of Issue
miley ete tes 1/19/2023

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

O For Services or Goods furnished

j@ Treasurer's refund/payment Refund

O Other:
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
VERIAED
q)a4 ley

me

S& State Farm

State Farm

_ —_

June 28, 2024

Maricopa COUNTY ASSESSOR

| authorize Lilia Vega to file claim to receive a new refund check.

Sincerely,

Amanda Guyer
Tax Manager

Like a good neighbor, State Farm is there:

Maricopa County Treasurer's Office

Refund ID 2023000275 MTG_BATCH

&. Refund ID 2023000275 MTG_BATCH
File Help

EJIey

= oO x

| Refund Amount: [52,287.42

Requester [MORTGAGE on 1/4/2023

| Refund Reason: [Mortgage Rejects - see attached list

Status: [DISBURSED on 14/2023

Slip 1D: {202300033

Address: [STATE FARM MUTUAL AUTO INSURANCE CO

CORP TAX D3-CPTR

Impounds | Stub | Comments |

Check Request [MORTGAGE DESK
Reference #; [MTGBATCH 00902

Impound #1. 2

Amount | Tax'Year | Statu

Parcel/Roll :|00000-000 Dest fund : [026

Source Fund { Linked |
| | 064 False $2,387.42 2022
|

<

REA) =cp#: — [0 Reso#: [0
CP buyer # :19 Phase #: oO

Mortgage code: [A540
> Transaction #: [MO A540

Impound Total: 1

Case #: J

Close

7/24/2024 8:00:43 AM

Maria Quitangon (TRS)

From: Christina Lopez (TRS)
Sent: Thursday, April 25, 2024 3:05 PM
To: Maria Quitangon (TRS)
Subject: RE: Mortgage refunds
Here you go.
PROGRAM ID: CSH FINISH_MTG_BATCH_POSTING 04-JAN- 2023
MARICOPA COUNTY TREASURER'S OFFICE PAGE: a
BATCH EXCEPTIONS REPORT
PAYMENT DATE: 29-DEC-2022
TRANSACTION: MO-A54Q
STATE FARM MUTUAL AUTO INSURANCE CO
CORP TAX D3-CPTR
BLOOMINGTON » IL 617100001
LOAN PARCEL TAX H TAX AMOUNT OVER/UNDER TRANS EXCEPTION
NUMBER NUMBER YEAR C OWED PAID AMOUNT TYPE REASON
24924 924-35-741 8 2022 F 605.02 921.26 316.24 06 e19
(MCTO Added) 944-89-796 6 2022 F 130.64 243.24 112.60 e6 @19
(MCTO Added) 944-89-811 4 2022. F 169.82 318.42 148.60 06 e19
(MCTO Added) 944-89-849 1 2022 F 278.10 554.14 276.04 06 e19
(MCTO Added) 944-89-858 1 2022 F 272.14 565.16 293.02 26 e19
(MCTO Added) 944-89-894 7 2022 F 91.50 182.88 91.38 @6 e19
(MCTO Added) 944-89-938 3 2022 F 109.36 201.44 92.08 @6 @19
(MCTO Added) 944-91-918 8 2022 F 266.60 470.32 203.72 86 19
(MCTO Added) 944-91-954 4 2022 F 319.80 553.00 233.20 @6 19
(MCTO Added) 944-92-067 8 2022 F 153.80 265.32 211.52 26 @19
(MCTO Added) 949-62-440 9 2022 F 170.76 350.32 179.56 06 e19
(MCTO Added) 951-78-807 7 2022 F 13.88 27.66 13.78 @6 e19
(MCTO Added) 952-81-085 4 2022 F 6.54 21.58 15.04 06 @19
(MCTO Added) 991-97-589 6 2022 F 129.64 255.34 125.70 @6 @19
(MCTO Added) 991-97-631 1 2622 F 151.68 277.80 126.12 06 e19
(MCTO Added) 992-25-262 4 2022 F 6.42 17.02 10.60 86 e19
24519 994-52-879 7 2022 F 1,558.04 1,596.26 38.22 06 e19

“OVERPAYMENTS: 2,387.42

REJECTED PAYMENTS: 9.00

EXCEPTION REASON DESCRIPTION

SR RA ae He a ee a

@@1 INVALID PARCEL, CONTACT ASSESSOR

@04 2ND HALF PAYMENT WITH FIRST HALF DUE
@13 PROBLEM WITH PAYMENT, CONTACT OUR OFFICE
@19 OVERPAYMENT

@20 UNDERPAYMENT

@24 RESOLUTION PENDING, CONTACT OUR OFFICE
@30 TAXES ALREADY PAID

@31 TAX LIEN EXISTS

@34 TAX LIEN PENDING

PROGRAM ID: CSH FINISH_MTG_BATCH_POSTING

MARICOPA COUNTY TREASURER'S OFFICE
BATCH REJECTED PAYMENTS REPORT
PAYMENT DATE: 29-DEC-2022

TOTAL OVERPAYMENTS: 2,387.42

CHRISTINA LOPEZ
TREASURER’S OFFICE

W
MARICOPA

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From: Maria Quitangon (TRS) Lc
Sent: Thursday, April 25, 2024 2:
To: Christina Lopez (TRS)

Subject: Mortgage refunds

Hi Christina,

Will you please give me the payment/refund information for this? Thanks.

04-JAN- 2623

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