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INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 4/30/2020 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.vsaguirre@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. #60 Higley Unified Shauna Miller $435.95 E. ,,.,EIVED zkolZg - MAY 29 2020 iviARicopkk couNTY CLERK BOARD OF SUPERVISORS warrant/ch ck be issued to him/her in (the sum of $ 435 . 95 .4 Signed: .(3) (4) Reason for original issue of Warrant/Check (8): El Payroll MARICOPA Ccu ID For Services or Goods furnished Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (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. Shauna Miller Name/Claimant (1), being first sworn, upon oath deposes and says: On or about 3/10/20 (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 (5) Subscribed and sworn to before me this ;2-0 day of (seal) NOTARY PUBLIC My commission expires: OFFICIAL SEAL JANE K BOSTON I ; Notary Pubic - Moto alArIzona MARICOPA COUNTY E, !Clot,/ Cann. 0555063 Exp. Nov. 8,2022! , 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) 3700293171 Original Date of Issue (if known) (7) 3/10/2020 " " 14 Other: Employee Reimbursement for travel S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 May 28, 2020 To Whom it May Concern: I did not receive the original check mailed to me for the reimbursement for the airline ticket. If you have any further questions, I can be reached at 480-228-0477. Respectfully, , ata/(MAAytt OA, 5/28 Shauna Miller 2,0