STAMPED & REDACTED - FOR AGENDA ATTACHMENT - ELIZABETH SMITH.PDF
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Office of the Maricopa County School Superintendent Steve Watson INTEROFFICE MEMORANDUM TO: MARICOPA COUNTY CLERK OF THE BOARD FROM: MCSS FINANCE DESK (ANDIE DE LA ROSA) SUBJECT: AFFIDAVITS -REPLACEMENT OF LOST WARRANTS DATE: 05/16/2024 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda. The attached item(s) have been researched to ensure that the warrant(s) in question have not been cashed or previously re-issued. The original warrant(s) have had a stop payment done. If you have any questions, please contact the MCSS Finance Desk at 602-372-4833 (Option 1) or via e-mail at FinanceDesk@maricopa.gov. Approved Affidavits may be routed back to the Superintendent of Schools - Finance Desk at 4041 N. Central Ave #1100. Thank you District Payee Warrant # Amount Paloma Dist #94 Smith, Elizabeth 3700668789 | $1,079.05 Date Amount Reissue WT # Office of the Maricopa County School Superintendent Finance Desk nim 20201016 Warrant Void/Stop Request District Name / Number: Paloma School District #94 Contact Name: [rma Garcia Attachments: [| Original Warrant Lost Warrant Affidavit (required for ALL reissues) [] Vendor Letter (if requesting Vendor reissue) Warrant Number Warrant Date | Amount (storting with “37") (mm/dd/yyyy) Payee (as it appears in Check Manager) Void Stop 3700668789) 7/12/2023 | $ 1,079.05 Elizabeth Smith = ©O Notes: District vowroree (UNG Diwit. pore: 05|15] 2004 For Internal Use Only Clerk of Board Date: Void Report Date: Schools Affidavit/Claim Form Application for a Duplicate Warrant/Check (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. Elizabeth Smith (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 1 jalaoaz (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 ¢1079.05 (3) Signed: GS Caglinlfasull. (4) (5) Subscribed and sworn to before me this |5@ day of ly ay 2aY. OITA Ur A NOTARY PUBLIC My en SESS 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 1370668789 _ oo ee =r 12/2023 Reason for original issue of Warrant/Check (8): C) Payroll O For Services or Goods furnished a = other: VElMbwsenwnb S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\S Revised June 2015 5/16/24, 3 26 PM Warrant Status Print Attachments v Warrant (1 - mcto) - Warrant number: 3700668789, Stopped VMware Horizon Maintain New Status Setup Attachments 3700668789 4 Warrant header General Posting Warrant number: Invoice: Holder: Invoice date: Issued date: 7/12/2023 12:00:00 am Paid date: Status: Stopped Positive pay sent date: 7/13/2023 09:00:07 am Exception flag: E ti ; en eee tone Agency voucher number: 1103 Queued for positive pay: Locked for reconcile: Registered Date registered: No of days interest: 0 Annual interest rate: 0.00000 4 Warrant Lines oO Amount Payee 1,079.05 ELIZABETH SMITH Agency claim number: Agency low orig: Agency PO number: Agency sub fund: Agency dept num: Account lq <4 > DI | 7 | ® | Identification of the warrant https //horizon maricopa gov/portal/webclient/#/desktop 1