Extracted text (via pymupdf)
2825 characters
INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 5/21/2020 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 terri.ysaguirrePmaricopa.gov . Approved Affidavits may be routed back to the Superintendent of School Finance Division at 4043. N. Central Avenue #1200, (12th Floor) Thank you. #95 Queen Creek Unified SR Mayra Martinez $100.00 RECEIVED MAY 2 7 2020 MARICOPA COUNTY CLERK BOARD OF SUPERVISORS livolvmmisa.00.40...7"CT Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (definitions are on page 2) STATE OF ARIZONA 11/4)\ 11/471; 1I4‘..4 ARctuICOrr44PAI Name/ ant Note: Numbers on this form correspond to numbers on the Instruction sheet which Is page 2 of this form. rIQ _ Z(1), being first sworn, upon oath deposes and says: On or about Y:k atat, (date)(2) a warrant/check was issued to the above named pers n/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, pi 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 $ 0 0 .(3) Signed: 64 Aki a ne4, (4) (5) Subscribed and sworn to before me this 3 day of 2020. ALWQfl atop aLt\'(--03.k/vriciI NOTARY PUBLIC y commission expires: zre LILLIAN ->:)R l'EGA CASTROYINCI WIWI Public - State of Altana MARICOPA COUNTY Commission # 550513 Expires June 27,2022 Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally Issued. Warrant/Check Number (If known) (6) "--1-- b 3 D7R—L1:4-- ,._ i,_:,, Original Date of Issue (If known) (7) H a 1 a -uat .A. P P ,,,, rtiv-r '4\ LIAV Reason for original Issue of Warrant/Check (8): Payroll ID For Services or Goods furnished ErrOther: 54-7(=,‘(- 815AFriD-OF1 SUP ERViSORS MARICOPA COUNTY C S:\PROCESSES\Warrants - Duplicate or StaleI02 Forms\Schools\Schools-Warrants Checks notice of clalm.doc Revised June 2015 A.R.S. 11-632 & 15-999 (seal)