REDACTED - FOR AGENDA ATTACHMENT - PETER WIKMAN #954808.PDF
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John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003
l
MA R) COPA COUNTY geen
TREASURER’S OFFICE http://treasurer.maricopa.gov
To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov
From: Treasurer’s Office
Maria Quitangon ML
maria.quitangon@maricopa.gov
602-506-1958
Cathy Sanchez ‘
cathy.sanchez@maricopa.gov
602-506-7881
Re: Stale Dated Warrant
Name Warrant Amount Dept/School
No
Peter Wikman 954808 $1,103.78 | Treasurer
rk LCO,
Application for a Duplicate or Stale-Dated Warrant/Check =a f
Affidavit/Claim Form cats
This application is for: O Duplicate or DA 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.
Peber Loy kwmean (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 2/24/24 (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 beina 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 igsued to him/her in the sum of $_|, 10% ,.7%8 .(3)
Ve
Signed: v (4)
\ @
Print name: (required) Peter Adi amen
Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.
- Ta |
(5) Subscribed and sworn to before me this eal day of May ey ie
NOTARY PUBLIC
GSR KAITLYN E BRAGA
ly a Notary Public - Arizona
RA } Maricopa County
S Commission # 647425
BA My Comm. Expires Mar 26, 2027
My commission expires:
Larch 26, 2027
Warrant/Check Number
(if known) (6) G5N808
Original Date of Issue
(if known) (7) as) ZH [ 23
Reason for original issue of Warrant/Check (8):
0 Payroll
QO) For Services or Goods furnished
(H Treasurer's refund/payment
O Other:
S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 A.R.S, 11-632 & 11-644
VERIFIED
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[Me
Maricopa County Treasurer's Office 131-11-061 3 6/5/2024 12:45:27 PM
fi 131-11-061 3 a x
File Help
Year_| Description [ActDate | TranNum_| Amount | Images | PmtDate | HalfCode | ActTime a
2022 DELINQUENT NOTICE 2023-06-01 Y 12:00:00 A
2021 REFUND 2023-04-20 $1,027.80 N 12:00:00 A
2020 REFUND 2023-04-20 $1,018.71 N 12:00:00 A
2019 REFUND 2023-04-20 $976.47 N 12:00:00 A
2021 REDEMPTION PAYMENT 2023-04-05 + 008-01921 $1,037.80 N 2023-03-31 10:23:00 A
2020 REDEMPTION PAYMENT 2023-04-05 008-01921 $1,028.71 N 2023-03-31 10:23:00 4
2019 REDEMPTION PAYMENT 2023-04-05 0089-01921 N 2023-03-31 10:23:00 4
202 N
008-01921
2022 TAX PAYMENT 2023.03.31 OF 10:23:00.4
REFUND 00:00 4a
< >
Parcel #: [131-11-061 Activity: JREFUND Act Date 02/24/23
Tax Year: [2018 Tran #:[- ies | Act Time {i200 AM
Activity Detail | Address Detail |
Buyer: figaaT Check #: [954808
|
| CP #: eonrsa4 Check Date: [02/24/23
|
|
Fund: j50 Refund Amount: | $1,103.78
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Maricopa County Treasurer's Office 6/5/2024 12:46:03 PM
x
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“Buyer Number [73491 Buyer Code: fr SSN: [477-920-9574
Name/Addiess
Copy
Name/Address
J¥ Outstanding [~ Redeemed [~ Expired [~ Extinguished
IRS Form Type [w-3-
CP. List CP Number | Parcel Number | t of Years ‘| Status
< z
Number of C.P.'s Displayed: 0
Maricopa County Treasurer's Office
Refund ID 2023002056 CP_BUYER
& Refund ID 2023002056 CP_BUYER
| Refund Amount: [si 103.78
Requester. [ECHECKWEB on 2/8/2023
| Refund Reason: cP Redemption refund
Status: [DISBURSED on 2/24/2023
Slip iD: [202300104
Addiess: IKMAN PETER
Impounds | Stub | Comments |
Check Request: [MAIL
Reference #: [CP 18007534
Source Fund | Linked |
Amount | TaxYea | Statu
050 True $1,103.78 2018
REAL
Impound #1
Parcel/Roll:|131-11-051 Dest fund: [050
CP #: 18007594 Reso #: Jo
CP buyer #13431 Phase tt: [0
Mortgage code: [
|
|
|
|
|
| Impound Total : 1
|
Transaction # : fori 60342
Case #: j
6/5/2024 12:46:44 PM