CORTEZ.PDF

Maricopa County — Formal (2020-04-22)

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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: 	
3/30/2020 
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 
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. 
#60 	 Higley Unified 	
Gregory Cortez 	 $372.54 
RECUIVED 
MAR 31 2020 
MAFVCOPA COUNTY 
CLERK BOARD OF SUPERVISORS

• , 	
7 
	(4) 
Signed: 
warrant/check be issuedo 
t himer in the sum of $  372 .54 
, 	
1.) 
I) 
NOTARY PU 9LIC 
My.commission expires: 
P\-fyi ( 	
7t7.12,  
NOTARY PUBLIC 
STATE OF ARIZONA 
Phial County 
MAYRA SALAMANCA 
My Commission Expires April OB. 202fse 
Schools Affidavit/Claim Form 
Application for a Duplicate 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. 
GREGORY CORTEZ 
Name/Claimant 
On or about 	
,r2 ,23 2 0 
	(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, 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 
(1), being first sworn, upon oath deposes and says: 
,(3) 
(5) Stibcribed and sworn)to zOefore me this  r)-.G( 
 day of  1.`-1(-6-.(/ (=K  20 9 
CX1/14 	
 
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) 
3700285629/60629866 
Original Date of Issue 
(if known) (71 
02/25/2020 
Reason for original issue of Warrant/Check (8): 
*I Payroll 
0 For Services or Goods furnished 	
 
0 Other: 	
 
SAPROCESSESWarrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of daim.doc 
Revised June 2015 	
A.R.S. 11-632 & 15-999