SATMPED & REDACTED BACK TO SCHOOL CLOTHING DRIVE.PDF
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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: 11/10/2021 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda Vv The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. Vv 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. #59 Laveen Elementary Back to School Clothing Drive $1,522.81 RECEIVED Nov 14 2021 MARC OUNTY ; CLERK BOA UPERVISORS Lytorngh wou - AF og Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/ Claim Form This application is for: Duplicate or C1 stale-Dated (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. BACK TO SCHOOL CLOTHING DRIVE (1) Name/Claimant ' being first sworn, upon oath deposes and says: On or about 02/11/2021 (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 warrant/check be issued to him/her in the sum of $1, 522.81 (3) Signed: Ginette Fic, (4) Note: pie. attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5) sue and sworn to before me this CD day (LL __ 20 ZL —— ae NOTARY PUBLIC ‘Net Pt. My commission Serres: Mertcopa County, Artzona UA- 2 - 7 My Comm, Exes 0228-28 (seal) Warrant/Check Number ee 3700398556 Original Date of Issue - (if known) (7) 02/11/2021 Reason for original issue of Warrant/Check (8): O Payroll 11/18/2021 For Services or Goods furnished QO Treasurer's refund/payment O Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice of claim - Copy.doc Revised April 2015 A.R.S, 11-632 & 11-644 “> @ back to school (‘momentum clothing drive ea entoeea October 20, 2021 | Karl Gentles, a representative of Back to School Clothing Drive, state that payment for goods or services provided to the Laveen school District was not received. The check in the amount of 1522.81 has been declared lost in the mail. Janette Lopez, also a representative of Back To School Clothing Drive, has presented an affidavit for signature before a Notary Public. KarLGentles Executive Director Pusey J te Lopez Director of Programs Phoenix AZ