STALLARD.PDF

Maricopa County — Formal (2020-06-10)

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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: 	
5/18/2020 
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 
terrLysaguirre@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. 
#65 	
Littleton Elementary 	
Linda M Stallard 	
$113.39 
RECE ED qio Ds. 
MAY 1 
MAR1COPA COUNTY 
CLERK BOARD OF SUPERVISORS

ANANIARIA OUINTANILLA 
Notary Public - State of Arizona 
MARICOPA COUNTY 
Commission #545714 
Expires May 15, 2022 
(seal) 
Schools Affidavit/Claim Form 
Application for a Duelicate 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. 
cc 	
-4- 16.v•ci 
	(1), being first sworn, upon oath deposes and says: 
On or about 	
7 )92) 10() 
	(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, ar 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 $  /13 
 
.(3) 
(4) 
(0 Subscribed and swpfp to before me tliis  / 	
day of 
NOTARY PUBLIC 
202-0. 
My, commission expires: 
ifICtb 1S , ?C) 
 
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 e_c) o c9c ,27cD / 
Original Date of Issue 
(if known) (7) 
7 APZ /49019 
Rea op for original issue of Warrant/Check (8): 
Payroll 
0 For Services or Goods furnished 	
 
0 Other: 	
 
SAPROCESSESWarrants - Duplicate or Stale\02 Forms\Schools‘Schools-Warrants Checks notice of dalm.doc 
Revised June 2015 	
A.R.S. 11-632 & 15-999