STAMPED LUPA TERESA LIVINGSTON.PDF
Extracted text (via ocr_local)
2623 characters
INTEROFFICE MEMORANDUM Maricopa County Schools Superintendent Office _ : TO: CLERK OF THE BOARD FROM: Terri Ysaguirre SUBJECT: Affidavits — Replacement of Lost Warrants DATE: — 8/5/2021 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. #25 Liberty Elementary Lupe Teresa Livingston $83.97 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. Lupe Livingston (1), being first sworn, upon oath deposes and says: Name/Claimant On or about Ay (3 ,205-\_ (date)(2) a warrant/check was issued to the above named pérson/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 her in the sum of $83.97 (3) sig 2 7 (4) warrant/check be issued to hi Signed: (5) Subscribed and sworn to before me this os day of d ola 2021. WN raDroh Calleccs NOTARY PUBLIC WrateatrCottins: Notary Public Maleah Collins Maricopa County, Arizona Notary Public My Comm. Expires 10-03-24 Maricopa County, Arizona Commission No. 589202 My Comm. Expires 10-03-24 Commission No. 5898@4l) My commission expii (0-03-24 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 arrant/Check Number 137090439829 Original Date of Issue chat ae ee 7/13/2021 Reason for original issue of Warrant/Check (8): @ Payroll 08/06/2021 O For Services or Goods furnished O Other: S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Checks notice of claim.doc Revised June 2015 ARS. 11-632 & 15-999