Extracted text (via pymupdf)
2486 characters
2W FEB 1 Maricopa County Human Resources Memo To: Fran McCarroll, Clerk of the Board From: Tiffany Parkerson Date: February 14, 2020 Re: Replacement of Lost Payroll Warrants Please find attached 1 Affidavit/Notice of Claim(s) for lost payroll 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. The original warrant(s) have had a stop payment done. Please call Tiffany at ext. 6-2406 for any questions. Please route approved Affidavits back to County Payroll, Suite 220. Stale Dated Warrant Thank you. Replacement Lost Warrant Form Duplicate Warrant 1 02/25/2015 warrant/check be issued to him/heWthe sum of $ 1,147.14 Signed: (seal) TIFFANY PARKERSON Notary Public. State of Arizona MARICOPA COUNTY My Commission Expires May 18. 2021 My commission expires: \ anc Original Date of Issue (if known) (7) 2/5/2020 Reason for original issue of Warrant/Check (8): Payroll LI For Services or Goods furnished 111 Treasurer's refund/payment LI Other: A A- DATE. 1FEB 18 202 MARICOPA COUN -r Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form Mg FEB I 1-} Pii 2:28 This application is for: STATE OF ARIZONA COUNTY OF MARICOPA Eric n f-rera5 Name/Claimant (1), being first sworn, upon oath deposes and says: On or about 2/5/2020 (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 Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) Subscribed and sworn to before me this ( 4 day of u1AO 2020 . Duplicate or El'Sfale-Dated (definitions are on page 2) Note: Numbers on this form correspond to numbers on the Instruction sheet which is page 2 of this form. .(3) _ NOTARY 11 Warrant/Check Number (if known) (6) 22698695 Revised April 2015 A.R.S. 11-632 & 11-644