STAMPED & REDACTED MOHAMED ABDELRAHMAN.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: 9/27/2021 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. 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. #59 Laveen Elementary Mohamed Abdelrahman $145.00 RECEIVED sep 28 2021 TY ARICOPA COUN CLERK BOARD OF SUPERVISORS Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: ml Duplicate or CO 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. Mohamed Abdelrahman Name/Claimant On or about 8/10/2021 (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. (1), being first sworn, upon oath deposes and says: 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 issuigd to him/her in the sum of $ 145.00 (3) Signed: _ = (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_ /@__day of September 20 21. ~~ Ar—~ NOTARY PUBLIC BRIAN REASOR wi 5 z Notary Public - Arizona My commission expires: Pinal County Commission # 583705 a) 2; OE, 2024 Ee” My Comm. Expires Jul 8, 2024 (seal) Warrant/Check Number AF keer) (6 3700455598 Original Date of Issue 8/10/2021 (if known) (7) Reason for original issue of Warrant/Check (8): O Payroll ll For Services or Goods furnished : - 09/29/2021 O Treasurer’s refund/payment W Other: Pavent refund 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 Terri Ysaguirre (CSS) From: FinanceDesk (CSS) Subject: FW: #3700455598 for $145 From: Sanchez, Cynthia Sent: Monday, September 27, 2021 10:25 AM To: FinanceDesk (CSS) Subject: #3700455598 for $145 Hello FinanceDesk, Parent Mohamed Abdelrahman was issued a refund check for preschool/childcare tuition. The parent and child moved away from the District. The refund check issued was declared lost in the mail. An affidavit has been submitted for the reissue of the check. Thank You, Cynthia Sanchez Accounts Payable Bookkeeper Laveen Elementary School District Phone: (602) Fax (602)