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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: 9/15/2021 Please find attached 1 Affidavit/Notice of Claim(s) for lost warrants for inclusion on the next available Board agenda v 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. #21 Murphy Elementary Daniel Lopez $1,772.51 RECEWED SEP 16 2024 gicoPA COUNTY ag CLERK BOARD OF SURERVISO \um “ 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. ‘ ie (1), being first sworn, upon oath deposes and says: ame/Claiman On or about 2) 3112021 (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, undef penalty of perjury, claimant hereby affirms that this claim is correct and the amount in is due and owing, and the applicant requests that a replacement issued to him/her in the sum of $ j1qa. e) ] (3) warrant/cheg Signed: / (4) ie. (5) Subscribed \ahal sworn to before me this _ | day of Suplenbor 200-). Sal | : TIFRANY IOFINSON M ission expires: J '&} Notary Public - State of Arizona By A7o— 5) YAVAPALCOUNTY (seal) Comm. #580001 Exp./July 28, 2022 Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. W. t/Check Numb ara | 21332553 Original Date of Issue (if known) (7) fey a 2) | ada-| Reason for original issue of Warrant/Check (8): Payroll OO For Services or Goods furnished 09/17/2021 O Other: - S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warran_ _..- Revised June 2015 A.R.S. 11-632 & 15-999