STAMPED & REDACTED - FOR AGENDA ATTACHMENT - SIANNA P GALINDO.PDF

Maricopa County — Formal (2024-07-24)

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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: 06/27/2024

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

Littleton Dist #65 Galindo, Sianna P 3700678554 $752.83

Date

Amount

Reissue WT #

Office of the Maricopa County
School Superintendent

Finance Desk
mim 20261016

Warrant Void/Stop Request

District Name / Number: Littleton Elementary School District #65

Contact Name: Juanita Morin

Attachments:

[] Original Warrant
Lost Warrant Affidavit (required for ALL reissues)

CJ Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date: | Amount Payée bce} Qe
(starting with “377} (mm/de/yyyy) {as it cppears In Check Manager) 2 & 3
3700678554 | 8/8/2023 | $ 752.83 Sianna P Galindo OO

© OU

@©oOU

'®O

Notes: lost in mail

District Approver:

Date:

For Internal Use Onty {3}
aad
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.
Sianna P Galindo (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about Yet: HR (date)(2) a warrant/check was Issued to the
above named persén/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 $752.83 (3)

Signed: Agta Li heob (4)

(5) Subscribed and sworn to before me this [ath day of June, 20.24 .

YO "laws SD Kurs |
NOTARY PUBLICL iy

MARIA D, KRIEGER
§2\ Notary Public. State of Arizona
&) 5) MARICOPA COUNTY
SS _ Commisston # 697013
rit Expires February 01, 2025 (seal)

My commission expires: _
Fe bare 0 {2025

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

Warrant/Check Number 3700678554.

Original Date of Issue
i (if known) (7) 8/8/ 23

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

O For Services or Goods furnished
O Other:

6/28/24
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools’
Revised June 2015

6/27/24, 5:28 PM

ps Warrant

Warrant (1 - mcto) - Warrant number 3700678554, Stopped

VMware Horizon

Lh RK lbte sy 64
mat Warrant ; Status | Print | Attachments
¥
Maintain New | Status | Setup | Attachments
3700678554

4 Warrant header
General

Warrant number;

Holder,

Issued cate; 8/8/2023 12:00:00 am
Status: Stopped
Exception flag: |
Exception season: None
Queued! for positive pay: | |
Locked forreconcile: | |
Registered

Date registered:

No of clays interests 0
Annual interest rate: 0,00000

4 Warrant Lines”

{2 Amount Payee
752.83 GALINDO, SANNA P

https://horizon.maricopa.gov/portal/webclient/#/desktop

Posting

lavoice:

Invoice date:

Paid date:

Pasitive pay sent date:

8/4/2023 12:00:56 pm

Agency details

Agency voucher number; 5
Agency claim number,
Agency low orig:

Agency PO number:

Agency sub fund;

Agency dept num:

Account

° | 8} | Identification of the warrant

11