CENTURYLINK.PDF

INTEROFFICE MEMORANDUM 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysaguirre 
SUBJECT: Affidavits — Replacement of Lost Warrants 
DATE: 	
6/10/2020 
Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next 
available Board agenda 
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.ysaguirre@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. 
#25 	
Liberty Elementary 	 Century Link Cust ID#C4840 	
$5,241.59 
RECEINIED Zip 
JUN 1 2 2020 
MARICORA 'COUNTY 
CLERK BOARD OF SUPERVISORS

(5)scribed and sworn to before me this 	
LS11—  day o 
cW 
Schools Affidavit/Claim Form 
Application for a Duplicate Warrant/Check  (definitions are on page 2) 
Note: Numbers on this form correspond to numbers on the 
Instruction sheet which is page 2 of this form. 
Name/Claimant 
On or about 	
,_;5 	
202/1) 
	(clate)(2) a warrant/check was issued to the 
above named person/en ity 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 
6, „,),/-1/ 
 
warrant/check be issued to him/her in the sum of $ 	
.(3) 
Signed 	
/./OOLLA 	
(4) 
STATE OF ARIZONA 
4 COUNTY.OF,MARICOPA 
CZ7.filarv 
(I), being first sworn, upon oath deposes and says: 
,hly commission expires: 
ARLYES DETTMANN 
Notary Public 
State of North Dakota 
My Commission Expires Sep 29, 2021 
(seal) 
_ 
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) 
37 
	 0 '32, 
JUN 
Original Date of Issue 
(if known) (7) 
3 I •),:;' 	
od0 
.. 	 : 
Reason for original issue of Warrant/Check (8): 
111 Payroll 
X For Services or Goods furnished 01/./# 5/0/ X641(.16Sg- 21):200 4-8 
0 Other: 	
 
5: \PROCE55t5 \Warrants - Duplicate or Stale \D2 Forms\Schools\Schools-Warrants Checks notice of claim.doc 
Revised June 2015 	
A.R.S. 11-632 & 15-999 
2020

It: CenturyLink- 
.1 rfr 
.. 	
1,•I 
June 3, 2020 
Liberty Elementary School District #25 
19871 W. Fremont Rd 
Buckeye, AZ 85236 
To whom it may concern: 
This letter is to verify that Michele Walter, Collections Specialist Ill, is authorized to sign the Affidavit. 
ARLYES DETTMANN 
Manager Finance Credit & Collections 
CenturyLink

MARICOPA COUNTY SCHOOL SUPERINTENDENT 
301 W. JEFFERSON, SUITE 660 
PHOENIX, AZ 85003 
TO: PAYROLL - ACCOUNTS PAYABLE 
PLEASE STOP PAYMENT AND REISSUETHE FOLLOWING WARRANT: 
/a-- 
DISTRICT NUMBER: 
PERSON REQUESTING 
PHONE #:  
N 
	
/ExT: 
STOP PAYMENT: 	
P1.5 
dihK 	e13-4711 46t7 	
--- 
WARRANT NUMBER: 37  -  0029032F3  WARRANT DATE:  3  1ö3  2.0  
(prefix) 	
(number) 	
(mm) (dd) (yy) 
PAYABLE TO: 	
rt-Lry 1;ni euff:To-m 61,o4a 
AMOUNT: 
FUND NO: 	
ociD 
	
VOUCHER NO:  
c tis:BS.-- 
 
CHECK ONE: 	 EXPENSE 	
PAYROLL 
REASON FOR STOP: 
67;14-zvo -r--m 
(LOST, DESTROYED, ETC.) 
ONE ORIGINAL AFFIDAVIT AND ONE COPY OF THE AFFIDAVIT ARE ATTACHED. PLEASE 
ISSUE A REPLACEMENT WARRANT. 
(FOR COUNTY USE ONLY) 
STATUS VERIFIED: 
STOP DATE: 
STOP VERIFIED: 
AFFIDAVIT SENT: 
AFFIDAVIT APPROVED: 
REPLACED: 
WARRANT #: 
RECONS RETURNED: STOP PREPAID 
H:\WorkILOST  WARRANT STOP-REISSUE COVER SHEET.Doc