STAMPED & REDACTED REMAX DESERT SHOWCASE.PDF

MARICOPA COUNTY

Office of Budget and Finance
301 West Jefferson

Phoenix, Arizona 85003

INTEROFFICE MEMORANDUM

Date: August 6, 2021 a —
RECEIVED
To: Clerk of the Board
AUG 06 2021
From: Walter Chang MARICOPA COUNTY
Office of Budget and Finance CLERK BOARD OF SUPERVISORS

Subject: Affidavits — Replacement of Lost Warrants

Please find attached 1 Affidavits for lost warrants 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 warrants have a void/stale date/stop payment done.

Please call me at 506-8747 if you have any questions. Please return the approved
affidavits to my attention in the Office of Budget and Finance.

Thank you.

Re: Fund : 222 / Dept: Human Services / Company: REMAX DESERT SHOWCASE

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

This application is for: Duplicate or C 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

paae 2 of this form.

REMAX DESERT SHOWCASE (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about 16-Jul-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 7 anaes 6,399.37 :(3)

Signed: ZO (4)

Note: Piéase _ a copy rt 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 a day of Agni” 2024 .
Dyidy. Duolitn - ardug

NOTARY PUBLIC

Seldy Judith Gardea
commission expires: Notary Public
At | |b» 402L Maricopa County, Arzena.

My Comm. Expires 01-03-202

Warrant/Check Number 3010093175

(if known) (6)

Original Date of Issue
(if known) (7) 16-Jul-2021

Reason for original issue of Warrant/Check (8):
OO Payroll
For Services or Goods furnished_/ rental assistance

QO Treasurer’s refund/payment
Other: / Original check presumed lost in the mail / fund : 222

S

x

08/06/2021

FISHER TEAM AZ — SALES & PROPERTY MANAGEMENT

REMIX

August 4, 2021

|, Andy Fisher, authorize, Alex Fisher, Assistant Manager, to execute an affidavit on behalf of RE/MAX

Desert Showcase.

Sincerely,
7
(pags Fab Aes Y 302/
Andy Kisher
Manager

Re/Max Desert Showcase

RE/MAX Desert Showcase

Peoria,
Direct:
Email:

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