REDACTED - FOR AGENDA ATTACHMENT - PETER WIKMAN #954895.PDF

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MARICOPA COUNTY

TREASURER’S OFFICE

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100

Phoenix, Arizona 85003
Phone: (602) 506-8511
Fax: (602) 506-1102

http://treasurer.maricopa.gov

To: Clerk of the Board

clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer's Office
Maria Quitangon hall
maria.quitangon@maricopa.gov
602-506-1958

Cathy Sanchez CSs

cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name

Warrant
No

Amount

Dept/School

Peter Wikman

954895

$723.53

Treasurer

ors
th Bas i

Oun’S.

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: oO Duplicate or al 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.
Perc “Wi aman (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about _7 ] LD | (25) (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 Wi the sum of $ 7 s) 35 .(3)
Signed: a, $L# (4)

i

Print name: (required) ‘Peter Wt Krew

Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

f (5) Subscribed ‘ sworn to before me this 3/°" day of May 20.2.

NOTARY PUBLIC

KAITLYN E BRAGA
Notary Public - Arizona
Maricopa County

My commission expires: E75) —_ Commission # 647425
Marc ja 2G ZO? 7 i My Comm. Expires Mar 26, 2027 (seal)

Warrant/Check Number F
(if known) (6) 9564 8%

Original Date of Issue
: (if known) (7) the / 23

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

OO For Services or Goods furnished

> 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
verirrey
é/sley

Mo

Maricopa County Treasurer's Office 149-53-063 5 6/5/2024 3:24:21 PM

FB 149-53-063 5 - x
File Help
Year _| Description [ActDate | TranNum | Amount | Images | Pmt Date | Half Code | Act Time a
2023. = DELINQUENT NOTICE 2024-06-03 N 12:00:00
2023. TAX BILL 2023-08-26 x. 12:00:00
2022 TAX PAYMENT 2023-07-13 071-42548 $35.83 N 2023-07-10 =F 6:31:00 F
2022 =DELINQUENT NOTICE 2023-06-01 id 12:00:00
2021 REFUND 2023-03-15 * $881.61 N 12:00:00
2020 REFUND : $857.49 N
2019 REFUND $719.04 N
2018 REFUND $767.98 N

REFUND

< >
Parcel #: [149-53-063 Activity: REFUND Act Date {02/28/23

Tax Year: [2017 Tran #: | - Ee Act Time {12:00 AM

Activity Detail | Address Detail |

CP #: {17008947 Check Date: [02728723
eee — Check: [SSISSE———
Fund [60 Refund Amount: | $723.53

Click icon for Disbursements Inquiry. -----> al

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Maricopa County Treasurer's Office

6/5/2024 3:24:27 PM

CLP. List

Name/Address

Copy
Name/Address

“Buyer Number 73491 BuyerCode: [7 SSN: [477.92-9574

x

¥ Outstanding [~— Redeemed [~ Expired [~ Extinguished

IRS Form Type fw

CP Number | ParcelNumber | Hof Years | Status

<

Number of C.P.'s Displayed: 0

Close

Maricopa County Treasurer's Office Refund ID 2023002903 CP_BUYER 6/5/2024 3:24:56 PM

&. Refund ID 2023002903 CP_BUYER = oO x
File Help
CIES
Refund Amount: [3723.53 Requester: |RAMONA. MORAN on 2/27/2023
Refund Reason: jcP Redemption refund Status: [DISBURSED on 2/28/2023

Slip ID: [202300110

Re IKMAN PETER Check Request: [MAIL
Reference # [CP 17008947

Cate}

Impounds | Stub | Comments |

Impound #1 e
|
| |_Source Fund | Linked | Amount | Tax Year | Status Parcel/Roll :[14953-063 Dest fund : [050
| 050 True $723.53 2017 READ! cPH#H: 77008947 Reso #t: oo

| CP buyer tt [13431 Phase tt: [0

Mottgagecode: [
= > Transaction #: [00801680

Impound Total: 1 Case #: | |