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Cy RECEIVED Ms \ SEP 25 2020 MARICO: SUBJECT: Affidavits — Replacement of Lost Warrants CLERK BOARD 0 DATE: 9/22/2020 TO: CLERK OF THE BOARD FROM: Terri Ysaguirre ITY =RVISORS 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. v 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. #95 Queen Creek Unified Deana Christine Schmidt $1,206.31 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. Schmidt, Deana Christine (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 1/28 | 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 ia" be issued to hia in the sum of 1, 206.31 (3) Signed:,—4 Bind E Ze Ze ‘Yd. eel (4) (5) Subscribed and sworn to before me this Ath day of September 2020: ; ML KAS NOTARY PUBLIC HEATHER RIEHL My commission expires: Het ARIGOPA COUNTY Commission # 577782 Expires February 4, 2024 (seal) O02 Low, Q02L/ 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: arrangcheck Number 13700338696 Original Date of Issue (if known) (7) 7/28/20 Reason for original issue of Warrant/Check (8): veg SEP 3 0 2020 ‘XL Payroll 0 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 Terri Ysaguirre (CSS) From: QCUSD, Payroll <payroll@qcusd.org> Sent: Monday, September 21, 2020 2:43 PM To: Terri Ysaguirre (CSS) Subject: Fwd: Replacement Check Attachments: Replacement Check 2,jpeg; Replacement Check,jpeg Categories: Red Category Hi Terri, Do you have a status on the attached paperwork for the replacement check? Thank you, Nicole Business Office-Payroll wnnenneen= Forwarded message --------- From: QCUSD, Payroll a! Subject: Replacement Check To: <Terri.Ysaguirre@maricopa.gov> Good morning Terri, Would you please replace the lost payroll check for Deana Christine Schmidt? The signed affidavit and the void form is attached. The originals will be delivered to you when we pick up the checks next Monday. Thank you, Nicole Hunt Business Office-Payroll Thursday September 24, 2020 To: Clerk of the Board Fr: Finance Desk — MCSS Please see attached Lost Warrant Request: $1,206.31 Deana Christine Schmidt 7/28/2020 The original Affidavit was dropped off at MCSS on Tuesday, September 9". | was tele-working from home on that day. When | returned to the office on September 10", | did find the District’s documents. Please accept this copy. Unfortunately, the District Employee is not cooperating with completing another Affidavit. If you have any questions, please contact me immediately. Thanks for your assistance. Terri Ysaguirre Finance Desk 602-372-1245