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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: 11/22/2019 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. #60 Higley Unified Carls Rent-A-Van $1,094.58 RECEIVED JAN 24 Zbatfte MARICOPA COUNTY CLERK BOARD OF SUPERVISORS warrant/check be issued to him/her in the sum of $ 1,094.58 .(3) RAMA AGNIHOTRI Notary Public - State of Florida Commission GG 144344 My Comm. Expires Jan 13, 2022 Berded through National Notary MD. 4 (seal) o • Is Affidavit/Claim Form 1Plication 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. Carts Rent-A-Van Name/Claimant On or about 07/30/2019 (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: 4.7A (5) Subscribed and sworn to before me this 5' day of A v„ ,„3,1R,20 i? . My commission expires: - 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) 3700207706 Original Date of Issue 07/30/2019 (if known) (7) Reason for original issue of Warrant/Check (8): El Payroll El For Services or Goods furnished Other: Van Rental S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 A.R.S. 11-632 & 15-999 / RENT A VAN 3011 4Cy Rd Orkthdo 11 32812 407-85(f-8866 407-S56-8868 Fa le(o Carts VanReat w Cti rIsVanRen IN.( a Web OR LANDO * " FT LA UDER.h.A.LE " CKSON E "iTh 'Whom it may Concern, ' ray pertnissiuu to Mt out the requested affidavit or t e st 1:11%nk you, Cxnurr.m 107 , 948-561 I