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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office mM V wey UZ, ds 0 " RECEIVED = 7 TO: CLERK OF THE BOARD SEP 08 2020 FROM: Terri Ysaguirre MARICOP; COU SUBJECT: Affidavits — Replacement of Lost Warrants CLERK BOARD OF SUPERVISORS DATE: 9/3/2020 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda v 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. #44 Avondale Elementary Daniela E Ball-Norman $580.00 Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/Claim Form This application is for: a Duplicate or O stale-Dated (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. BALL-NORMAN, DANIELA E (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 8/18/2020 (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 neds Gs S— @) 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 be issued to him/her in the sum of $980.00 K()) (5) Subscribed and sworn to before me this 28 day of Pafas- 220, Lhe a NOTARY PUBLIC pe ALEX VASQUEZ Notary Public - Arizona Gey Maricopa County M <a Commission # 574697 commission expires: , yy Y Doo? ce” My Comin, Exp. November 19, 2028 focal ae Warrant/Check Numbe rrant/check Number | 3700345100 Original Date of Issue gine" if nown) 7) 8/18/2020 Reason for original issue of Warrant/Check (8): Payroll C1 For Services or Goods furnished 4 2 -}seP 9 9 2020 O1 Treasurer's refund/payment : pei O Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 ARS. 11-632 & 11-644