KEVIN MCCORMICK.PDF

Maricopa County — Formal (2020-02-12)

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If.lECEIVED 
'JAN 17 2020 
- - -4.4ARIC=C1P-AZQUNTY-_-- 
CLERK BOARD OF SUPERVISORS 
Maricopa County Schools Superintendent Office 
TO: 	
CLERK OF THE BOARD 
FROM: 	
Terri Ysaguirre 
SUBJECT: Affidavits - Replacement of Lost Warrants 
DATE: 	
1/16/2020 
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. 
#95 	 Queen Creek Unified 	
Kevin McCormick 	 $177.31 
INTEROFFICE MEMORANDUM

warrant/check be issued to him/h 
Signed: 
My commission expires: 
(2002-02-1-- 
DESIREE AGUILAR 
Notary.Public-State of Arizona 
MARICOPA COUNTY 
My Commission Expires 
April 11,2022 	
 
411/MINK 
Zilw—K, BOARD OF SUPERVISORS 
MAR1COPA COUNTY 
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. 
VEVII4  MC Cee"t0"-- 
	(1), being first sworn, upon oath deposes and says: 
On or about 	
10t2-2.-‘201c) 
Name/Clarrnant 
(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 
in the sum of $ 	
I 
-(3) 
(4) 
(5) Sqbscribed and sworn to before me this 	
tg-  day of 
(seat) 
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) 
-7)---yi 534 1 ct 56% ocz 0 
Original Date of Issue 
(if known) (7) 
10 I 7:2. 1 I 9 
Rewn for original issue of Warrant/Check (8): 
Payroll 
Li For Services or Goods furnished 
El Other: 
SAPROCESSESMarrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc 
Revised June 2015 	
A.R.S. 11-632 & 15-999