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Rer JAN 17 4C.1,..) CLERki—OARD 0—F SUPERVISORS-- INTEROFFICE MEMORANumvi Maricopa County Schools Superintendent Office TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: 1/15/2020 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.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. #5 Isaac Elementary Grant Youth Park Project $400.00 Schools Affidavit/Claim Form pplication for a Duplicate Warrant/Check (definitions are on page 2) Signed: (4) NOTARY PUBLIC My commission expires: II- e Marie Notary Pub* -ARIZONA MARICOPA COUNTY Commission No. nage ay Commission lopkes 1112912020 (seal) 1. CLERK, BOARD OF SU PERvisi: MARIOOPA COUNTY STATE OF ARIZONA Note: Numbers on this form correspond to numbers on the COUNTY OF NIARICOPA instruction sheet which is page 2 of this form. 6-0/- Plori `gd (1), being first sworn, upon oath deposes and sa ys: )\,161/ On or about .em a warrant/check was issued to the 1,2018 (date)(2) above named person/entity in the amount as stated below. Such warrant/check was either never received or was subse quently inadvertently lost or destroyed and there is no reasonable probability of its being found or presented for pa yment, gl it was not presented for payment within one year after the data 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 re quests that a replacement A100 warrant/checkbfissjledjo/ iim/her in the sum of $ 00 .(3) (5) Subscribed and sworn to before me this Ci day of ;Vow,/ c_ 20 /cr MOO& 5. Thaeloa Note: Please attach a copy of the warrant/check if avallaWe and/or any other evidence that a warrant/check was originally issued. Warrant/Check Number (If known) (61 3—) 00;/:(Fl 5q6 Original pate of Issue (If known) (7) SI fig Reason for ori ginal issue of Warrant/Check (8): 0 Payroll y) For Services or Goods furnished 0 Other: SAPROCESSES\Warrants - Duplicate ol. Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 Earl and Mary Rose Wilcox Grant Park Barrio Youth Project Inc. c( F P f: ,Sijraj.r h- 14( Ze7/7 ( ic:cwr, 706, 0/", sty , (-2A, /°5;S /4 (IVY d74 te c/A, See f Zt`s/r-/ 11P-( oke Jr 01) VpW/ 1///07 ZO: a07/7///z, c cA p, 117 W. Grant • Phoenix, Arizona 85003 • 602-739-5900 Juanita Garza (COB) From: Sent: To: Subject: Attachments: Tern Ysaguirre (CSS) Wednesday, January 22, 2020 2:50 PM Juanita Garza (COB) Warrant #3700209595 Sniplmage.JPG Juanita, Is this okay for the status? A Stop Payment was placed by our office because it came into our office as a lost Check. Please let me know if you need anything else. Thanks, Terri Ysaguirre i lr AU warrants (Unsaved 5Iter) - I370020959S 1 ..1NaccanE ..., . E Agency -•• Status- Warrant number Issued date Paid date Amount ., 5005 ' Sto 370020950.5 . 8111201g 1240:00 ani 400,00' , I. Wanant numben .3700209595 Amount Payee Account 400-00 GRANT YOUTH PARK PROJECT 210100-510-5005-5040-50342-41