STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MIRANDA SUMMERS.PDF

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: 04/30/2024

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

Isaac Dist #5 Summers, Miranda 3700754388 $1,437.75

Date.

Amount

Relssue WT ##

Office of the Maricopa County

School Superintendent

Finance Desk
mm 20201016

Warrant Void/Stop Request

District Name / Number: Isaac School District

Contact Name: Cinthia Morales

Attachments:

[] Original Warrant
Lost Warrant Affidavit {required for ALL reissues)

L ] Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date: .| Amount Payee Seow
(starting with “37>) (mm/dd/yy) (cs it'appears in Check Manager) g z B

a
3700754388 4/8/2024 | $ 1,437.75 Summers, Miranda ©OYv

Notes: Check was maild out 04/12/2024 However employee has not recived it.

District Approver: Cinthia Morales

Date: 4/29/2024

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,
SUMMERS, MIRANDA (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 04/08/2024 (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/hjm/her In the sum of $ $1437.75 (3)

Signed: , [ Lee az (4)
L\7

(5) Subscribed and sworn to before me this _24__day of Apr | 2025,

(thors Bin

NOTARY PUBLIC

CATHERINE ROMERO
Notary Pubile - Azone
|e} MARIGOPA COUNTY
S Cammisslan # 636396
Expires Sept. 24, 2026 (seal)

My commission expires:
04/08/2024 Sept: 2y, 2026

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 13790754388

(if known) (6)

Original Date of Issue 04/08/2024

(if known} (7)

Reason for original issue of Warrant/Check (8):
Payroll

For Services or Goods furnished
) Other:

4/30/24

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\¢
Revised June 2015

4/30/24, 8:24 AM
Warrant (1 - meto) - Warrant number: 3700754388, Stopped
c a 7 / | Warrant

VMware Horizon

A Vitis j G7) y
bait Warrant | Status | Print | Attachments
a
Maintain New Status | Setup | Attachments ee _
3700754388
“a Warrant header
General Posting
Warrant number: invoice:
Holder: Invaice date:
Issued date: 4/8/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date; 4/8/2024
Exception flag: Ll Agency details
Exception reason: None Agency voucher number: MAN
Queued for positive pay: |.“ Agency claim number:
Agency low orig:

Locked forreconcile: | | Agency PO number:
Registered Agency sub fund:
Oate registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0.00000

12:00:15 pm

“a Warrant Lines
ol Amount | Payee
1,437.75 SUMMERS, MIRANDA

| Account

htlps://horizon.maricopa.gov/pertal/webclient/#/desktop

| pj | Identification of the warrant

1