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REr- JAN 17 Clr0ARD OF SUPERVISORS-- INTEROFFICE MEMORANDUM _ 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.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 Jamie Glen $925.39 warrant/check be issged to him/her in the sum of $ .(3) Signed! (5) Subscr, (4) end swoiAto before me this cii " day of DectrAeAr 20 I . NOTARY PU My commission expires: 3 —2.cre.1 JENNIFER GIANZERO NotaryPublk-StstsolArtans PINALCOUNTY My Commission Ervin August03, 2021 oe Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (definitions are on page 2) STATE OF ARIZONA COUNTY OF MARICOPA Note: Numbers on this form correspond to numbers on the Instruction sheet which is page 2 of this form. Name/Claimant On or about tol \ k°1 (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. Warrant/Check Number (if known) (6) 3-1(.1)13L-1 to73 Original Date of Issue (if known) (7) \ '`.1 VI (1), being first sworn, upon oath deposes and says: Re7n for original issue of Warrant/Check (8): Payroll El For Services or Goods furnished CI Other; DATE N_2 3_202 .41111111te; ii 1?-7-, ar tr•-• — • MARICOPA COUNTY SAPROCESSES\Warrants - Duplicate or Stale \02 Forms\Schools\5chools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S, 11-632 & 15-999