STAMPED & REDACTED - FOR AGENDA ATTACHMENT - RACHEL M VLIEK.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: 07/02/2024

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 Vliek, Rachel M 3700678542 $721.35

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk
° t By f,
School Superintendent fran, 22040 %6

Warrant Void/Stop Request

District Name / Number: Littleton Elementary School District #65 | Atechments:
Contact Name: Juanita Morin J Original Warrant
Contact e-mail: P Lost Warrant Affidavit (required for ALL reissues)
[ ] Vendor Letter (if requesting Vendor reissue)
Warrant Number Warrant Date | Amount Payee. os 2: ®
(starting: with "37") (mm/dd/yyyy) {os it appears in Check Manager) 2 2 g
é

3700678542) 8/8/2023 | $ 721.35 Rachel M Vliek

Notes: jost in mail reissue

District Approval a ~

For Internal Use Only
Clerk of Board Date: © Void Report Date:

BLCO
i ee

ar,

COuN’S

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.

Rachel M. Vliek (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about y. ug ust £, BERD (date)(2) a warrant/check was issued to the
above named pers6d/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

nee) be issued Jerhinyher | in the sum of $721.35 8)

Signed? PY lr CC oD od (4)

(5) Subscribed and sworn to before me this ‘Q auth day of JUNE. 2024

nue AD K Lotte)

NOTARY PUBLIC

MARIA D. KRIEGER
Notary Publio- State of Arizona
MARICOPA COUNTY
Commission # 597813
Expires February 01, 2025)

My commission expires:

Mary ©2625

(seal)

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

sreiromm is ~_|3700678542

Original Date of Issue
3 (if known) (7) 8/8/2023

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

O For Services or Goods furnished
1 Other:

S;\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools 7/ 8/ 24
Revised June 2015 : .

7/2124, 3:29 PM
fal Warrant (1 - mecto) - Warrant number: 3700678542, Stopped
' e | Warrant |

Alulin d = | » ff )
fais Warrant | Status | Print | Attachments
¥
_ __ Maintain _ New Status | Setup Attachments _
3700678542

VMware Horizon

4 Warrant header

General Posting

Warrant number: Invoice:

Holder: Invoice date:

Issued date: 8/8/2023 12:00:00 am Paid date:

Status: Stopped Positive pay sent date: 8/4/2023 12:00:56 pm

Exception flag: i]

Agency detalls

Exception reasont None

Agency voucher number; 5

Queued for positive pay: |]

Agency claim number

Agency low orig:

Locked forreconcile; {4 {

Agency PO number;
Registered Agency sub fund;
Date registered: Agency dept num:
No of days interest: 0
Annual interest rater 0,00000
4 Warrant Lines eee
{J Amount - Payee Account

72435 VLIEK, RACHEL M

If dis bm bE | 12) | Identification of the warrant

httos://horizon.maricopa.gov/portal/webclient#idesktop