VILLA.PDF

Maricopa County — Formal (2020-06-10)

View PDF Item 99 Meeting page

Extracted text (via pymupdf) 2646 characters
INTEROFFICE MEMORANDUM 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysaguirre 
SUBJECT: Affidavits — Replacement of Lost Warrants 
DATE: 	
5/22/2020 
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.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. 
#65 	
Littleton Elementary 	
Marvin Villa 	$1,125.16 
RECFIVFn 
MAY 2 6 
MARICORA COUNTY 
CLERK BOARD OF SUPERVISORS

NOTARY PU 
My commission expires: 
i\JcAiettrt.ixr  
Signed: 
A 
(4) 
swo o before me this 	
day of  I Intl 
	2000 , 
la • ..11Pr 
(5)Subscribed an 
ELBA M. LOZANO 
Notary ipublic - Slate of Arizona 
MARICOPA COUNTY 
My Commission Expires 
November 27, 2021 
(seal) 
Schools Affidavit/Claim Form 
Application for a Duecate Warrant/Check (definitions are on page 2) 
STATE OF ARIZONA 
COUNTY OF MARICOPA 
v‘% 	
lla 
Note: Numbers on this form correspond to numbers on the 
Instruction sheet which Is page 2 of this form. 
(1), being first sworn, upon oath deposes and says: 
ame/Ciaimant 
On or about 	
7_C)2.6(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, gr 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 $ //c35 -. /6p 	
.(3) 
Note: Please attach a copy of the warrant/check If available and/or any other 
evidence that a warranVcheck was originally Issued. 
Warrant/Check Number 
Of known) (6) 
37 0056 c?36 9 
Original Date of Issue 
(if known) (7) 
Liii 
 
Reason for original issue of Warrant/Check (8): 
Payroll 
or Services or Goods furnished 	
 
DATE 
M4Y-2 7 2020 
CLERK BOt 
AI • 
0 Other: 	
 
S:\PROCESSES\Warraflts  - Duplicate or Stale\02 Forms\Schools\Sc..hools-Warrants Checks notice of dalm.doc 
Revised June 2015 	
A.R.S. 11-632 & 15-999