STAMPED & REDACTED - FOR AGENDA ATTACHMENT - THERESA DOWLING.PDF

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

Laveen Dist #59 Dowling, Theresa 3700672352 $590.57

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent cm 20201016

Warrant Void/Stop Request

District Name / Number: Laveen Elementary #59 Attachments:
Contact Name: Brenda Long Original Warrant .
Contact on Lost Warrant Affidavit {required for ALL reissues)
[] Vendor Leiter (if requesting Vendor reissue)
Warrant Number Warrant Date | Amount Payee
{storting with 37") (rom/dd/yyyy) (es it appears in Check Manager}

Void
Stop
e-issue

59118957 | 08/01/2023 | 590.57 Theresa Dowling ~ oO
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Notes: Lost Check

careronmn Lov 17-3

For Internal Use Only

Clerk of Board Date: Void Report Date:

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (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.

Poulan, Woes __(1), being first sworn, upon oath deposes and says:
Name/Claimant- 7

On or about 02/ 01/2024 (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 ye in the sum of $_ @70-97 3)
Signed: bheaen e ES SS (4)
\_)
——
(5) Subscribed and sworn to before me this “2___day of _c/ure. 202Y.

Bahu YL

NOTARY PUBLIC

6SiiQm, STEPHANIE NIEHUS

Keyreatey Nolary Pils - State of izona
I} MARICOPA COUNTY

(J Corimisslon # 696822 (seal)
Expkes Septembar 27, 2024

My commission expires:
G37 ar

Note, Please. attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

Warrant/Check Number Sanger | 44-00 Wt27G2 Ad

Original Date of Issue
Sie ie mewn} (7) 0%) ol [ GOL
Reason for original issue of Warrant/Check (8):
Payroll

C1 For Services or Goods furnished
O Other: } 6/21/24

S:\PROCESSES\Wartrants ~ Duplicate or Stale\02 Forms\Schools\Sch:
Revised June 2015

6/19/24, 8:48 AM
Warrant (1 - mcto) - Warrant number: 3700672352, Stopped
: | Warrant |

Klahe ff

VMware Horizon

bith Warrant | Status | Print | Attachments
¥
Maintain New Status | Setup | Attachments
3700672352
“a Warrant header — Oo 7
General Pasting
Warrant number: 3700572352) Invoice:
Holden Invoice date:
Issued date: 8/172023 12:00:00 arn Paid date:
Status: Stopped Positive pay sent date; 7/24/2023 09:00:17 ani
Exception flag: i| Agency details
Exception reason: None
. Agency voucher number: 3

Queued far positive pay: }| Agency claim number

Agency iow orig:
Locked for reconcite; | | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num:
No of clays interest: 0
Annual interest rate: 0,00000

7 venaaia ~

0 Amount : Payee » Account

590,57 Dowling, Theresa

fq ios & pl | ee | 23) | Identification of the warrant

htlps://horizon.maricopa.gov/portal/webcllent/#/desktap

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