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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 Ann M Catlin $319.42 RECEIVED -4110 I L MAY 2 6 ?It'' MAR1COPA COUNTY CLERK BOARD OF SUPERVISOR* MAY 2, -- I A T Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: 0 Duplicate or El Stale-Dated (definitions are on page 2) STATE OF ARIZONA ircc Numbers on this Hu)) )))**))))))11 )1» )))))))1r) on the COUNTY OF MARICOPA v / ) (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 7 y=7.)) C)) Cj (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, gE 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 issyed to him/her in the sum of $ .(3) Signed: (4) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued, )))))..)))) sheet ») )) ) ))) ) of this )»)r) efore me this (5)Subscribed and svyprn -- rr 41 1 , day of MA " • rE: LL BB AA MM 11__00ZA ZAILO C Notary Public - State of Arizona MARICOPA COUNTY My Commission Expires November 27, 2021 NOTARY PUB My commission expires: tA).keratoer- fl,, 20 O. (seal) Warrant/Check Number Of known) (6) 3706 Original Date of Issue (if known) (7) 74?0 /02o/9 Reasop for original issue of Warrant/Check (8): Payroll • For Services or Goods furnished O Treasurer's refund/payment O Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S. 11-632 & 11-644