MILLER.PDF

Maricopa County — Formal (2020-06-24)

View PDF Item 138 Meeting page

Extracted text (via pymupdf) 2942 characters
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