STAMPED & REDCATED PATRICIA O'BRIEN VELTEN .PDF

MARICOPA COUNTY
Department of Finance

301 West Jefferson, Ste 960
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM
Date: November 3, 2021
To: Clerk of the Board

From: Maria Meza
Department of Finance/Accounts Payable

Subject: _Affidavit- VC-1334 PATRICIA O'BRIEN VELTEN W#3010094800 8/2/21 $3600.00

Please find the attached Affidavit for a duplicate warrant to be included on the next
available Board Agenda.

e The attached items have been researched to ensure the warrant in question
have not been cashed or previously re-issued.

e The original warrant is lost.

Please return the approved Affidavits to my attention in the Department of Finance, Suite
960 or email to MARIA.MEZA@MARICOPA.GOV.
| may be reached at 602-506-1379 if you have any questions.

Thank you.

Re: Fund: 222, Dept. 220 Human Services, GAX1D 22*1222

10/8/2021

Application for a Duplicate or Stale-Dated Warrant/Check 5 |
Affidavit/Claim Form cones

This application is for: [] Duplicate or LJ Stale-Dated (definitions are on page 2)

STATE OF ARIZONA Note: Numbers on this form correspond to
COUNTY OF MARICOPA numbers on the Instruction sheet which is
pade 2 of this form.
AT RTE 1), being first sworn, upon oath deposes and says:

On or about 02-Aug-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 $3,600.00 (3)

Signed: Lptre we 0. e lée-7 (4)

Note: Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

(5) Subscribed and sworn to before me this_ ©!" dayof_ tov 202/.,
NOTARY PUBJAC
My commission expires: No ARICOPA COUNTY
| CZ te wv 20 eae coe (seal)
| Warrant/Check Number lan
(if known) (6)
Original Date of Issue |02-Aug-2021
(if known) (7)

Reason for original issue of Warrant/Check (8):

1 Payroll
1 For Services or Goods furnished

O Treasurer’s refund/pa OU oe
Other: 220 RENTAL ASSIS }TANCE-CK NOT RECEIVED _

D220
GAX1D 22-1222

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY WARRANT NUMBER
3010094800

PHOENIX, ARIZONA

DATE
08-02-2021 0901-21221
Three Thousand Six Hundred And 00/100 Dollars
$3,600.00
PAY TO THE ORDER OF
PATRICIA O'BRIEN VELTEN ba MOUNT
Void After
365 Days

For Questions - or email
MARICOPA COUNTY DEPARTMENT OF FINANCE

NOT NEGOTIABLE

RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT

YOUR RECORDS

PATRICIA O'BRIEN VELTEN 3010094800 08/02/2021 $3,600.00
PURCHASE ORDER NO. | VOUCHER NO. AMOUNT

INVOICE NUMBER | DESCRIPTION

GAX1D D220 220000001222 3,600.00

INV-0000094790 ANNA BUSTAMANTE RENTAL ASSISTANCE
220000001222

10/8/21, 11:26 AM

Status
Account #
Paid Date
Issued Date
Registered Date
Payee
Amount
Interest
Claim #
Sub Fund
Dept #
PO#
LowOrig

Voucher

DashBoard

Warrant Number - 3010094800

08/02/2021
PATRICIA O'BRIEN VELTEN

$3600.00
$0.00

https://treasurer.maricopa.gov/AgencyWeb/Dashboard#

11

7/29/2021

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Maria Meza (FIN)

‘om: Trish Velten <tvelten@yahoo.com>
sent: Thursday, October 7, 2021 1:46 PM
To: FIN AccountsPayable
Subject: Uncashed check

Hi Sheryl, thank you so much for your assistance. | have so many major things going on in my life right now and am not
keeping up as well as | need to. | have misplaced and not cashed the mentioned check and | would so appreciate your
assistance in the re-issuance of the check. The client name is: Anna Bustamonte. The warrant number is
000003010094800. The case is: CAS81324-X6KOH6. If you could have the check reissued and mailed to me at my
Nevada address | will be watching for it. If you have any questions please don’t hesitate to contact me. Once again-
thank you. tvelten@yahoo.com. Patricia Velten. 2905 Salado Creek Ave. North Las Vegas, NV. 89081

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