STAMPED & REDACTED RAQUEL DIAZ.PDF

MARICOPA COUNTY
Department of Finance

301 West Jefferson, Ste 960
Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: October 13, 2021
To: Clerk of the Board
From: Maria Meza

Department of Finance/Accounts Payable

Subject: Affidavit— VS-4938 Raquel Diaz W#3010095047 8/4/21 $8600.00

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

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

e The original warrant is lost.

Please return the approved Affidavit to my attention in the Department of Finance, Suite
960. | may also be reached at 602-506-1379

Thank you.

Re: Fund: 222, Dept. 220 Human Services, GAX1D 22*1464

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

This application is for: ivi Duplicate or (7 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
page 2 of this form.

VS-4938 RAQUEL DIAZ (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 04-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 replacernent

warrant/check be issued to him/her in the sum of $ 8,600.00 -(3)
Signed: A Reise, A q Ks — (4)

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

(5) Subgcribed and sworn to before me this lA day of OCH 202 L

NOTARY PUBLIC ee
My Feny Clu On (seal)
a
ial che ita 3010095047
Original ral (sue 04-Aug-2021
Reason for original issue of Warrant/Check (8): Jona
1 Payroll

(1 For Services or Goods furnished

O Treasurer's refund/payment
Other; 9220 RENTAL ASSISTANCE- CK NOT RECEIVED BY VENDOR

|

Raquel Diaz

10,11.21

|, Raquel Diaz, authorize, Raquel Diaz (as the sole proprietor with no employees), to execute an affidavit
on behalf of Raquel Diaz.

Your truly,

ng toe Pad
aquebiaz

Sole Proprietor with no employees

county expensewarrant TREASURER OF MARICOPA COUNTY — WARRANT NUMBER
3010095047

PHOENIX, ARIZONA

eel
pas

ha A DATE

() aes ( 0809-202) 91-2224
CoG oo

Eight Thousand Six Hundred And 00/100 Dollars

$8,600.00

AMOUNT

PAY TO THE ORDER OF
Raquel Diaz
Void After
365 Days

For Questions - or emai. NOT NEGOTIABLE
MARICOPA COUNTY DEPARTMENT OF FINANCE
RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT
YOUR RECORDS
Raquel Diaz 3010095047 08/04/2021 $8,600.00
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
INV-0000097109 RENTAL ASSISTANCE DIAZ, CAROLYN. GAX1D D220 220000001464 8,600.00
220000001464

1013/21, 4:34 PM

. Status
: Account #
Paid Date

Issued Date

‘ Registered Date

: Payee
Amount

Interest

Claim #
Dept #

: LowOrig

Voucher

DashBoard
Warrant Number - 3010095047

Issued

08/04/2024

Raquel Diaz

"$8600.00

$0.00

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

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Maria Meza (FIN)

vom: Raquel Diaz <
sent: Friday, October 1, 2021 1:40 PM
To: FIN AccountsPayable; Raquel Diaz
Subject: Check Re Issue Request

Hello Finance Department.
| would like to request that you resend a check. | have not recieved the original which qas mailed the beginning of

August. It was in reference to rental assistance associated with the following information:

Client Name: Carolyn Diaz
Warrant Number: 3010095047
Case No: CAS-82401-D8C1Z3

Please let me know if there is anything further that | need to do to ensure the check is reissued and sent to me. Just in
case, my mailing address is

Warm Regards,
Raquel Diaz

Maria Meza (FIN)

rom: FIN AccountsPayable
fo: Raquel Diaz; FIN AccountsPayable; Jamie Shaver (HSD)
Cc: Maria Meza (FIN); Joyce Maurmann (FIN); Nicole Kasting (FIN)
Subject: RE: Check Re Issue Request
Hello Raquel

Warrant has not been returned, looks like the address the check has is the correct address. We will be placing a stop
payment and reissue once the attached paperwork is completed and sent back to us. Let us know if you have additional

questions. Thanks

SE YOSRRANT

Eight Thousand Siz Hundred And 00/100 Dollars

PAY TO THE ORDER OF
Raquel Diaz

SEY DEPART

OF &

TREASURER OF MARICOPA COUNTY

PRGENIX, ARIZONA

DATE

ORAS 2002]

Yoid Atter
a8 Days

WARRAN

3016:

1-2 221

pponceac
AMOUNT

SOF R

RETAIN TIESTOR |
YOUR RECURDS

sO. | WARRANT DATE FWARR:
Raquel Di HOTMONS HE? USL i

INVOICE NUMBER

PURCILASE ORDER 8G.

VOUCHER NO,

INV-GO00087103

RENTAL ASSISTANCE DIAZ, GAROLYN.

GAXID 0220
22000000 1484

220000001464

CLIENT: DIAZ, CAROLYN Pending Ee

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Maria Meza
Accounts Payable
Maricopa County Department of Finance

, MARICOPA. COUNTY

enBooks

‘om: Raquel Diaz
vent: Friday, October 1, 2021 1:40 PM
To: FIN AccountsPayable < ; Raquel Diaz <
Subject: Check Re Issue Request

Hello Finance Department.
| would like to request that you resend a check. | have not recieved the original which qas mailed the beginning of
‘ugust. It was in reference to rental assistance associated with the following information:

Client Name: Carolyn Diaz
Warrant Number: 3010095047
Case No: CAS-82401-D8C1Z3

Please let me know if there is anything further that | need to do to ensure the check is reissued and sent to me. Just in
case, my mailing address is

Warm Regards,
Raquel Diaz