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INTEROFFICE MEMORANDUM
Maricopa County Schools Superintendent Office
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 7/30/2020
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.
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.
#49 Palo Verde Elementary Therapy Matter, Inc $4612.50
RECEIVED *°"35.
AUG 03 2020
MARICOPA eo
CLERK BOARD OF
INTY
PERVISORS
Ce) me
ih af {
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Cound
Schools Affidavit/Claim Form i
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.
Ur es Tne (1), being first sworn, upon oath deposes and says:
ame/Claima
On or about March 10, Z0ZO_ (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 $ L. b) a.50 (3)
; ; .
"Signed: LP ll ZZ (4)
Z Z L
7
((S) Substribed and sworn to befgre me this_94 day of _\ wwe 2020.
DEAN BABB
Notary Public - Arizona
Maricopa County
Commission # $73890
My Comm. Expires Nov 14, 2023
My ae expires:
/ (seal)
i} 4 [203%
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
onelPao | BAo/zozo Ay, NOM
Reason for original issue of Warrant/Check (8): oe
O Payroll
ft For Services or Goods furnished by | het ply Matters \ “Inc
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)
IRIE aS
From: Marcia Conner <mconner@pvesd.org>
Sent: Friday, July 24, 2020 7:27 AM
To: Terri Ysaguirre (CSS)
Subject: Fwd: Check
Categories: Red Category
woecenaeae Forwarded message ---------
From: Jonathan Elovitz <jonathan@therapymatters.org>
Date: Thu, Jul 23, 2020 at 11:50 PM
Subject: Check
To: Marcia Conner <mconner@pvesd.org>
Hello,
1am the person who signed the Affidavit and an authorized signer. | did not receive the original check in question,
hence the reason it was not deposited.
Best,
Jonathan Elovitz, President/CEO
480) 382-0604
Therapy Matters, Inc. | Kylee’s Angels
1334 E Chandler Blvd 5A01
Phoenix AZ 85048
Live in the Moment and BE the Miracle!
Please see our new website: www.therapymatters.org
www.facebook.com/therapymattersinc
Marcia Conner
Accounting Assistant
Palo Verde Elementary District
10700 S. Palo Verde Rd.
PO Box 108
Palo Verde, AZ 85343
623-327-3690