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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office U 1g, Of#7 2 RECEIVED maz/i TO: CLERK OF THE BOARD FROM: Terri Ysaguirre AUG 25 2020 SUBJECT: Affidavits — Replacement of Lost Warrants CLERK BOARD OF SUES aiSORS DATE: 8/24/2020 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. #2 Riverside Elementary Elisabeth G Minzer $99.97 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. Elisabeth G Minzer (1), being first sworn, upon oath deposes and says: Name/Claimant On or about July 1, 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 $99.97 .(3) Signed: _ Maan pom (4) (5) Subscribed and sworn to before me this aor day of Lugust 2020. NOTARY PUBLIC MARIA CARBAJAL Notary Public - Arizona Kae My commission expires: gi ); Maricopa County wt Commission # 552942 duly 12020 Y My Comm, Expires Oct 5, 2022 (seal) 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 3700333783 (if known) (6) Original Date of Issue July 8, 2020 — a a (if known) (7) Reason for original issue of Warrant/Check (8): STESK BOARD O) Payroll CO For Services or Goods furnished Reimbursement of Expense Other: Reimbursement of Expense 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