TURNER.PDF

INTEROFFICE MEMORANDUM JUN 25 299
Maricopa County Schools Superintendent Office CLERK INC COPA County
D OF supe;
RVISORS .
CLA >
TO: CLERK OF THE BOARD (l

FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 6/18/2020

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.

#60 —_ Higley Unified Alissa Turner $56.15

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.

Alissa Turner (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 3/25/2020 (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 $ 56.15 (3)

Signed: —liesga lt (MLN) (4)

(5) exec ied and sworn io Refore methis_ (1 day of {uw e 20_)¢

NOTARY PUBLIC ©<__ LEAH GRUZ
2) Notary Public - Arizona
My commission expires: ie} MARIGOPA coun
pOt te 99S 49) Commission # 570 (seal)

Explres October 26, 2023

Note, Please attach a copy of the warrani/check if available and/or any other

evidence that a warrant/check was originally issued.

Warrant/Check Number 1799996983

(if known) (6)

Original Date of Issue 03/25/2020

(if. known) (7)

Reason for original issue of Warrant/Check (8):
1 Payroll

O1 For Services or Goods furnished
Other: Reimbursement for Travel

S:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc
Revised June 2015 ARS, 11-632 & 15-999

To whom it may concern:

The check sent to my address for my travel reimbursement was sent to an old address and was never
received. Please process a replacement check. My signed Affidavit is attached.

Sincerely,

baliinerd

Alissa Turner