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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office. —_ RECEIVED 0 OCT 27 2020 ai MARICOPA Co SUBJECT: Affidavits — Replacement of Lost Warrants CLERK BOARD OF SUPERVISORS DATE: 10/26/2020 TO: CLERK OF THE BOARD FROM: Terri Ysaguirre \ Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board 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 terri.ysaguirre@maricopa.gov. Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor) Thank you. #201 Buckeye Union Karen Sanders $523.12 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. Karen Sanders (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 96/18/2020 (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 $ 523.12 .(3) Signed: oe ui D> Z “andere (4) (5) ify worn to before me this 30" day of Sateec 20.20_. NOTARY PUBLIC MATTHEW WASHBURN Notary Public - State of Arizona MARICOPA COUNTY Commission # 583333 Expires May 07, 2024 (seal) My commission expires: pore, 0OW0Y 2014 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 13700327470 (if known) (6) Original Date of Issue (if known) (7) Reason for original issue of Warrant/Check (8): Sega : O Payroll a <a Ae OO 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 1000 East Narramore Avenue 5 —NS Buckeye, Arizona 85326 P: (623) 386-9700 #: (6x3) 386-9923 Buckeye Union High School District www.buhsd.org ~ ~~ Serving the Southwest Valley Since 1921 FF _ Buckeye Union High School 1000 E. Narramore Ave. Buckeye, AZ 85326 P: 623-386-4423 F: 623-386-9711 Laura, I was expecting a check for reimbursement for $523.12. I was informed that the check was cut and sent out. However, it has never reached me. I am requesting a replacement check. Estrella Foothills High School Thank you ) 13033 S. Estrella Parkway Goodyear, AZ 85338 P: 623-327-2470 F: 623-327-2499 D (> Karen Sanders Buckeye Learning Center 751 N 215" Ave Buckeye, AZ. 85326 ksanders@buhsd.org Youngker High School 3000 S. Apache Rd. Buckeye, AZ 85326 P: 623-474-0100 F: 623-474-0200 Pa The Learning Center 751 N. 215" Ave. Buckeye, AZ 85326 P: 623-474-0332 F: 623-386-1340