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INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
O
RECEIVED ‘io
TO: CLERK OF THE BOARD ; Nc
a SEP 08 2020 0
FROM: Terri Ysaguirre
MARICOPA COUNTY
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.
#05 Isaac Elementary Image Stuff.com $165.90
Schaols Affidavit/Claim Form iy
Application for a Duplicate Warrant/Checle Cefinitions eve on page 2)
STATE OF ARIZONA iNote: Numbers on this form correspond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this for.
ree. St uff ‘ Com (1), being first sworn, upon oath deposes and says:
ame/Claimant
On or about lo- {0 IQ (date)(2) a warrant/check was issued to the
above named person/entity in the arnount as stated below. Such warrani/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, ox it was not
presented for payrnent 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/®stied to him/her in the sum of $. l 06. a0 (3)
Signed: jn— (4)
|
(5) Subscribettind sworn to before me this /§: Me day of Lowpust 2020 .
Yrviz(puonnd Ctuiteate
NOTARY PUBLIC
‘arama
oii, MARIA ROSARIO BAUTISTA
% Notary Public, State of Texas
Comm. Expires 08-01-2021 peal)
Notary ID 131229268
2 S
Chit.
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrani/check was originally issued.
Warrant/Check Number
known) (6) 3) - O0ae 0460
Original Date of Issue
(if known) (7) (2-0-1
Reason for original issue of Warrant/Check (8):
1 Payroll
gh For Services or Goods furnished
© Other: ————
S:\PROCESSES\Wairanis - Duplicate or Stale\02 Forms\Schools\Schools-Watrents Checks notice of dain.doc
Revised June 2015 AR.S. 11-632 & 15-999
www, ScnoolLife.carn
PO Bax 1876
Camarilio, CA 93014
T: 877-773-7705
F; 877-563-3616
kim@schoolilfe.com
a division of ImageStuff.com
August 31, 2020
Isaac School District
3348 W. McDowell Road
Phoenix, AZ 85009
To Whom It May Concern,
Thank you for working with us to resolve your outstanding invoice
200026351 in the amount of $165.90 dated August 26, 2019.
We have sent the notarized affidavit on 2 separate times. Juli DellaLibera
did sign the first affidavit and she is an authorized signer for School Life, a
div. of imagestuff.
Please let me know if you have any questions or if if you néed any
additional information. Stay safe & healthy!
Kind Regards,
Kim Madey
School Life