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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: 5/22/2020 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