CALLES_REDACTED.PDF

Maricopa County — Formal (2020-06-24)

View PDF Item 138 Meeting page

Extracted text (via pymupdf) 3614 characters
INTEROFFICE MEMORANDUM 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysaguirre 
SUBJECT: Affidavits — Replacement of Lost Warrants 
DATE: 	
6/8/2020 
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. 
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 
terrLysaguirre@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. 
#59 	
Laveen Elementary 	
Jeremy CaIles 	
$5,000.00 
	
 co,0 
RECEIVED ov-iLs- 
eivc-t\ 
JUN 0 9 2020 
MARICOPA COUNTY 
CLERK BOARD OF SUPERVISORS

(seal) 
JOYCE C. COUNCIL 
Notary Public State of Arizona 
MARICOPA COUNTY 
My Commission Expires 
September 11, 2021 
My commission expires: 
yruil //, a?a?/  
K r OTOKR 0-OF SUPERVISORS 
NIA7,C0';\ 	
OCL:NTY 
Application for a Duplicate or Stale-Dated Warrant/Check 
Affidavit/Claim Form 
This application is for: 	
 Duplicate or 0 Stale-Dated (definitions are on page 2) 
STATE OF ARIZONA 
COUNTY OF MARICOPA 
Note: Numbers on this form correspond to numbers on the 
Instruction sheet which is page 2 of this form. 
Jeremy CaIles 
Name/Claimant 
On or about 	
March 26, 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 $ Five Thousand and no/100 dollares . (3) 
Signed: 
(4) 
Note: vPlease attach a copy of the warrant/check if available and/or any other 
evidence that a warrant/check was originally issued. 
(5) Subscribed and sworn to before rneThis 
/.5'614-  day of _ 
6Lia4tel 
 
NOTARY P BLIC 
20,22,5  
(1), being first sworn, upon oath deposes and says: 
Warrant/Check Number 
(if known) (6)  
3700298360 
Original Date of Issue 
(if known) (7)  
3/26/2020 
Reason for original issue of Warrant/Check (8): 
El Payroll 
For Services or Goods furnished 
El Treasurer's refund/payment 	
 
LI Other: 	
 
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

May 15, 2020 
Laveen Elementary School District 
Attention: Sally Perschbacher 
5001 W Dobbins Road 
Laveen, AZ 85339 
Dear Ms. Perschbacher, 
It has come to my attention that the check that was originally mailed to me on 3/30/20 was sent to an 
old address and as of this date it has not been forwarded by the Post Office. If you can send me a 
replacement check to my new address which you have confirmed is now updated in your system then I 
would appreciate it. Thank you.

Warrant Number - 3700298360 
Status 	
Issued 
Account # 
Paid Date 
Issued Date 
Registered Date 
Payee 
Amount 
Interest 
Claim # 
Sub Fund 
Dept # 
PO # 
LowOrig 
Voucher 
03/26/2020 
Jeremy CaIles 
$5000.00 
2173 
DashBoard 	
Page 1 of 1 
https://treasurer.maricopa.gov/Agency  Web/Dashboard 	
6/1/2020