LAURENCE E BIRD.PDF

Maricopa County — Formal (2020-12-09)

View PDF Item 136 Meeting page

Extracted text (via ocr_local) 2660 characters
INTEROFFICE MEMORANDUM

/ Maricopa County Schools Superintendent Office —

YO: CLERK OF THE BOARD

FROM: Terri Ysaguirre

SUBJECT: Affidavits ~ Replacement of Lost Warrants
DATE: 11/28/2020

Please find attached 1 Affidavit/Notice of Claim(s) fer lost warrants for inclusion on the next
available Beard agenda

Vv The attached item(s) have been researched to ensure that the warrant(s) in question have
not been cashed or previously re-issued,

Vv The original warrant(s) have had a stop payment done,

If you have any questions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at
terr.ysagulrre@maricopa.zov. Approved Affidavits may be routed back to the Superintendent
of Scheol Finance Division at 4041 N. Central Avenue #1200, (12th Floor)

Thank yeu,

#95 Queen Creek Unified Shawndra R Bird $1,518.10 (1 of 2)

#95 Queen Creek Unified Shawndra R Bird $1,518.10 (2 of 2)
Pris Queen Creek Unified Laurence E Bird $1,828.34

DS
RECEIVED 2 hac

NOV 8 0 2028

MARICOPS 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.
Laurence Edwin Bird (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about lif fal eee) (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

== to him/her in the sum of $ 1,828.34 (3)
ianed: ee en ee (4)

Signed;

~ (5) Subscribed and sworn to before me this Vio" day of Aavember 20.20.
Vi =

NOTARY PUBLIC

digs commie q, Sof

DANA SLOA\
nau, set on
1
Commission # B0174 (seal)

Expires August 9, 2024

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

Wi t/Check Numb
arent Gieccnombes a 700372024

Original Date of Issue
(if known) (7) 1 1/1 7/20

Reason for original issue of Warrant/Check (8): V 3,0 2020
@ Payroll

O For Services or Goods furnished
OO 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