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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: 7/22/2020
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.
#216 Agua Fria Union Jose Barajas $200.00
DS
RECEIVED ="
JUL 24 2020 ©
MARICOPA COUNTY
CLERK BOARD CF SUPERVISORS
‘Application for a Duplicate or Stale-Dated Warrant/ Check
-Affidavit/Claim Form
This application is for: kl Duplicate or CI 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.
Jose Barajas (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about January 09, 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 $200.00 (3)
Signed: _ Jer Re. Jha. (4)
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
(5) Sybscribed and 7'y to before me this 4 day of (Yldrci\__ 20 2V.
i
1A 7 —
, Te OFFICIALSEAL
NOTARY PUBLIC i BIANCAPERDOMO |
Notary Public - State of Arizona
MARICOPA COUNTY !
"Expires Apil 27, 2024 j
Mall My Com. Ee ena (seal)
My commission expires:
Warrant/Check Number 3700270867
(if known) (6)
Original Date of Issue
(if known) (7) January 09, 2020
Reason for original issue of Warrant/Check (8):
O Payroll
O1 For Services or Goods furnished
O Treasurer’s refund/payment
fj Other: Student reimbursement
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc
Revised April 2015 A.R.S, 11-632 & 11-644
Natividad Barajas
June 25, 2020
To Whom It May Concern:
My son Jose Barajas was promised a reimbursement check for turning in what was assumed a
lost chrome book. He initially paid the $200 fee. After it was found, the school told my son that
he would receive a reimbursement check through the mail. We waited for months and nothing
came back. We got in contact with the school and they replied that the check was already sent.
But after months coming back empty handed, the school approved to send another check and
cancel the previous check. | personally went down to the school to notarize and verify my
address before it was sent out. To this day, a second check has not arrived. We got in contact
with the school again and they replied that the second check was sent weeks ago. The school
advised to check with my postal office, but nothing was found there. Our frustration grows as
we continue to go back and forth. The school advise us to write this formal letter for the district
to let them know about the situation. | ask that if anyone can help me sort out this dilemma, |
would really appreciate it. | can be reached at
Thank you for your time,
Plese Cal) Mu
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Natividad Barajas
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