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Maricopa County — Formal (2020-06-24)

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INTEROFFICE MEMORANDUM 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysa guirre 
SUBJECT: Affidavits — Replacement of Lost Warrants 
DATE: 	
5/26/2020 
Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next 
available Board a genda 
V 	
The attached item(s) have been researched to ensure that the warrant(s) in q uestion have 
not been cashed or previousl y re-issued. 
V 	
The original warrant(s) have had a stop pa yment done. 
If you have any q uestions, please contact Terri Ysaguirre at 602-372-1245 or via e-mail at 
terri.ysaguirre@maricopa.gov . Approved Affidavits ma y be routed back to the Superintendent 
of School Finance Division at 4041 N. Central Avenue #1200, (12th Floor) 
Thank you. 
#25 	
Liberty Elementary 	
Helen Coreas-Mendez 	 $53.17 
RECEIVED 
iLig--44M0 
MARICOPA COUNTY 
CLERK BOARD OF SUPERVISORS 
RECEIVED 
MAY 2 7 201 
ts a 
MARICOPA COUNTY 
CLERK BOARD OF SUPERVISORS

Signed 
(4) 
(seal) 
NOTARY PUBLIC 
My commission expires: 
'1-1-r1_13 
 
DEvy LJACkSON 
NOTARY Public - STATE of ARIZONA 
MAR ICOPA COUNTY 
MY Comm, ExpiREs JAN. 3, 2022 
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. 
ameruiarrnan 
On or about  / 	0/9 
	
(date)(2) a warrant/check was issued to the 
above named per on 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/che* be issued to him/her in the sum of $ 	 /7 
	
-(3) 
), being first sworn, upon oath deposes and says: 
(5) Subscribed and sworn to before me this  `3--. 	
day of  kl\-0-4 s„ 	20 10 . 
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) 
... 
o 
Original Date of Issue 
(if known) (7) 
_ 
1 
APPUO 
• 	Silts n 
DAT 
Reason for original issue of Warrant/Check (8): 
0 Payroll 
K 11.7)A7-0F
RVOt 
MARICOPA COUNTY 
For Services or Goods furnished 	
_ 
0 Other: 	
 
SAPROCESSESWVarrants - Dupliate or 5tale\02 Fanns\Schools\Schools-Warrants Checks notice of cialm.doc 
Revised June 2015 	
A.R.S. 11-632 8i. 15-999

Terri Ysaguirre (CSS) 
From: 
Sent: 
To: 
Subject: 
Christine Molitor <
1 
Tuesday, May 26, 2020 11:57 AM 
Terri Ysaguirre (CSS) 
LESD#25: Voided Check Letter 
This is to confirm that Liberty's employee Helen Coreas-Mendez void request is for mileage 
reimbursement and paid from accounts payable purchase order# 200436 and not payroll. 
Thank you, 
Chris Molitor 
Accounts Payable Specialist 
Liberty Elementary School District 
623-474-6616 
Statements di Invoices may be sent to: 
accounts.payable@liberty25.orq