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INTEROFFICE MEMOBANDUM Maricopa County Schools Superintendent Office FO: ELERK OF THE BOARD PROM: = Terr ¥saguirre SUBJECT: Affidavits ~ Replacement of Lost Warrants BATE: 14/25/2020 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion en the next available Beard agenda v ‘The attached item(s) have been researched to ensure that the warrant(s) in queation have not been cashed or previously re-issued. ¥ The ariginal warrant(s) have had a step payment dane, lf you have any questlens, please contact Terri ¥saguirre at 602-372-1245 ar via gmail at terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent of Scheol Finanee Division at 4041 N, Central Avenue #1200, (12th Floor) Thank yeu, HOS Queen Creek Unified Carolyn € Whiting $471.28 #95 Queen Creek Unified Jill M Hagler §932,08 RECEIVED Doraw NOV 3 0 223 MARICOF-A COUNTY CLERK BOARD OF SUPERVISORS 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. Jill Michelle Hagler (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 11/3/20 (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 to him/her in the sum of $ 932.09 s(3) Signed: QO (a ia = (4) (To (5) sugetibed and sworn to before airy l J day of 1 iv qembso 3.0 NOTARY PUBLIC DONNA WATERS iat : Notary Public - State of Arizona My commission expires: MARICOPA COUNTY 4443/20 + Z Commission # 577778 < i Expires February 4, 2024 (seal) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. Wrenfgman io” [3700368805 Original Date of Issue : (if known) (7) 1 1 /3/20 Payroll “Fe for original issue of Warrant/Check (8): For Services or Goods furnished O Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S, 11-632 & 15-999