STAMPED AND REDACTED - 3010239158 - JEANNETTE MACKIN.PDF
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To: Clerk of the Board From: Office of Budget & Finance, Accounts Payable Date: 6-8-2026 Subject: Affidavit ― Replacement of Lost Warrant Please find attached one Affidavit for a lost warrant to be included on the next available Board Agenda. • The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. • The original warrant is presumed lost. Please call Walter Chang at 506-8747 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9th Floor. Thank you. Re: Fund : 296 / Dept : Human Services / vendor name : JEANNETTE MACKIN Office of Budget & Finance 301 W. Jefferson St., 9th Floor Phoenix, Arizona 85003 P: 602-506-3561 F: 602-506-4451 Maricopa.gov z . - -- - - --- -- - - .._--.:;;:_.J.!::1.Q-----(1 ), bei fir / laim t epo o b u U :/ 1 ( ate) 2) a a ran /check as • s e ov a-e e on/ -... ,t • h -ou s ated e ow. S ch wa rant/check w s e·t e eve c iv d o was s s qu t y ·nadve e tly ost or destroyed a the e ·s no reasonab e probabi • y o i s e1 g to nd or presen ed for payment, or it was o presen e for ay-e t wi ·n o e year after he da e of • ssuance • Thereto e, nde pe a y o perj ry, c a·mant hereby a fi ms t at i c a - is co rect a d e a, o nt shown ·s d e a d owing, a d the applicant re uests hat a rep ace-...e-- warra • /c eek be issued ..,., Pb/her n the s .,_ of$ la ':>(, 0 . (3) Sig ed: ,........__ _ _..._ ----'' J._ ________ (4) Print • am : req ired) -..::..r: .e V\ • • ote: Please attach a copy of the warrant/check if available an.d/or any other evidence that a warrant/check was originally issued. (5) Subscribed a d sworn o before me this tf day o ---=-J-=-U_Y\_e ___ 2 ..... -& ....,,. . Warrant/Check umber (if known) (6) or·ginal at,e of. ssue (if known) (7) y 17 . eason for origi al jssue of Warrant/C eek (8): s Payro I _________________________ _ Fa Services or Goo s furn·shed - ------------------ □ reasureVrefu /paymen -:------:--. __________________ _ 0 her: ;(_ --- D S:\PROCESSES\Warrants - Duplica e or Stafe\02 o s Curre t Claim I orm\ 100518 W . ts c eeks otice of claim.doc Re is9