Extracted text (via ocr_local)
5875 characters
RECEIVED
JUN 2 3 2020
INTEROFFICE MEMORANDUM
ee _ _ aoe MARICOPA_COUNTY
Maricopa County Schools Superintendent OfficecLERK BOARD OF SUPERVISORS
“inne
Ofte
Key
TO: CLERK OF THE BOARD
FROM: Terri Ysaguirre
SUBJECT: Affidavits — Replacement of Lost Warrants
DATE: 6/22/2020
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.
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.
#402 West-MEC Chad Williams $120.00
#402 West-MEC Chad Williams $114.00
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.
( J 2), \ Acura S (1), being first sworn, upon oath deposes and says:
jame/Claiman'
On or about January 22. ba (date)(2) a warrant/check was issued to the
above named person/enitity 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 $__} 44.00 (3)
Signed: Prelit Miarms (4)
LE scribed and swo} fore me this [[TA day of JUAG 2020.
“NOTARY PUBLIC “
ZACHARY LARSEN
M cnn ; Notary Public - en aus
is: ‘ MARICOPA
Ue an Commission # 681008
t Expires April 21, 2024 (seal)
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
W C N = ~ ;
Original Date of Issue
9 (if known) (7) \ | na | Acad %
yy ULA 7 20
Reason for original issue of Warrant/Check (8):
O Payroll Ne
C1 For Services or Goods furnished
OY othe: Sovaemrie eyvouryy, eau
1
S:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of clalm.doc
Revised June 2015 {) \ ARS, 11-632 & 15-999
al
\
\
Christina Pina
From: Kendra Odle <kendra.odle@west-mec.org> on behalf of Kendra Odle
Sent: Tuesday, June 2, 2020 12:00 PM
To: Christina Pina
Subject: Chad Williams missing pay checks
Hello Christina,
Chad Williams has reported that he has two missing paychecks. The checks would cover invoice dates
of service for July 15, 2019 - July 19, 2019 and January 7, 2020 - January 16, 2020, He did not receive
either check in the mail. Please reissue these two checks.
Thank you so much,
Kendra Odle
Administrative Assistant
Professional Development
G@ ) West-MEC PD
FF pdcicclewestmecorg
START@West-MEC 5405 N, 99th Ave « Glendale, AZ 85305
Phone ¢ 623.738.0023 | Email » kendra.odle@west-mec.ora | Website » west-mec.edu
Register for your next professional development opportunity:
https:/pdcircle.west-mec.org/
Schools Affidavit/ Claim Form
Application for a Duplicate Warrant/Checlk (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.
Chota W) Wenn S (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about Tulu aw, an (date)(2) a warrant/check was issued to the
above named person/éntity 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 $__| LAO. 00 (3)
Signed: dk tibhhiors (4)
(5) Subscribed and sworffto before me this {TS day of DUKE 20 Me.
a
“NOTARY PUBLIC ‘
My rorpmissign expires: WMARIGOPACOUNTY
Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
Ww t/Check Numb -
arancheck MMe | 24-HOmMOat ABE
Original Date of Issue
gine" known) () LI Alo lavniN
Reason for original issue of Warrant/Check (8): ULO7 2020
O Payroll / ip
C1 For Services or Goods furnished,
[Y Other: Student ater Oay
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notlce of clalm.doc
Revised June 2015 ARS. 11-632 & 15-999
)
|
Christina Pina
From: Kendra Odle <kendra.odle@west-mec.org> on behalf of Kendra Odle
Sent: Tuesday, June 2, 2020 12:00 PM
To: Christina Pina
Subject: Chad Williams missing pay checks
Hello Christina,
Chad Williams has reported that he has two missing paychecks. The checks would cover invoice dates
of service for July 15, 2019 - July 19, 2019 and January 7, 2020 ~ January 16, 2020. He did not receive
either check in the mail. Please reissue these two checks.
Thank you so much,
Kendra Odle
Administrative Assistant
Professional Development
“@\) West-MEC PD
pacliclewestnec.org
START@West-MEC 5405 N, 99th Ave « Glendale, AZ 85305
Phone 623.738.0023 | Email » kendra.odle@west-mec.org | Website » west-mec.edu
Register for your next professional development opportunity:
hites /accirel ~-mec.ora/