STAMPED & REDACTED - FOR AGENDA ATTACHMENT - DOUGLAS T THOMPSON.PDF
Extracted text (via ocr_local)
4087 characters
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: 06/21/2024 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 Queen Creek Dist #95 Thompson, Douglas T 3700769548 $256.09 a Amount Date. Office of the Maricopa County School Superintendent District Name / Number: QCUSD / 95 Contact Name: KATHY SAXTON Finance Desk mam 20201016 Warrant Void/Stop Request Attachments: LJ Original Warrant Lost Warrant Affidavit (required for ALL reissues) C_] Vendor Letter (if requesting Vendor reissue) Warrant Number}: Warrant Date (starting with 937) | tnmJad//yyyy) Amount Payee. = (ost appedes in ‘Check Manager}: ‘ 3700769548] 5/28/2024 | $ 256.09 THOMPSON, DOUGLAS T Notes: Check lost District Approver: AG Date: @fn/e4 Reissue WT # For Internal Use Only Clerk of Board Date: Void Report Date: Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (definitions aro on page 2) STATE OF ARIZONA Note: Numbers on thls form correspond to numbers on the COUNTY OF MARICOPA Instruction sheet which Is page 2 of this form: THOMPSON, DOUGLAS T (1), being first sworn, upon oath deposes and says! Name/Craimant On or about _“> jag | 2004 (date)(2) @ 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 fost 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 ¢ 256.09 (3) Signed: Werwbac f : (eon — (4) (5) Subscribed and sworn to before me this \U day of (SY 20, oY Viterk Mov, NOTARY PUBEIC MIRANDA BRANOT nexpires; Notary Publ Ke Aika pao P Siale of Noh Dakota My Commission Expires Sept. 14, 2026p (Seal) Note, Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. writin 6 _| 3700769548 ! Original Date of Issue 5/28/2024 Reason for original issue of Warrant/Check (8): 6/21/24 f Payroll © For Services or Goods furnished O Other: S:\PROCESSES\Warrants - Duplicate or Stale\2 Forms\Schools\Schools-Warrants Checks notice of chim.doc Revised June 201: ARS, 11-632 & 15-999 6/19/24, 2:55 PM Warrant (1 - mcto) - Warrant number 3700769548, Stopped he | Warrant | VMware Horizon ot Alahs Hs | ey t j Yoni Warrant | Status | Print | Attachments + Maintain New Status | Setup | Attachments 3700769548 4 Warrant header : General Posting Warrant number: 3700769548) invoice: Holden Invoice date: Issued dates Paid dates Status: Stopped Positive pay sent date; Exception flag: F cep ton leg 1.1 Agency details ecept SOM *eeptban fea an None Agency voucher number: 36 Queued for positive pays ‘| Agency claim number Agency Jow orig: Locked for reconcile: | | Agency 9 number: Registered Agency sub fund: Date registered: Agency dept num: No of days interest: 0 Annual interest rate: 0.00000 a Warrant Lines ~ : mi Amount Payee Account 256,09 THOMPSON, DOUGLAS T lq aie https:/fhorizon.maricopa.gov/portal/webclient/#/desktop & bl | ee | 8) | Identification of the warrant Ww