STAMPED & REDACTED - FOR AGENDA ATTACHMENT - RACHAEL D. DICARLO.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: 04/29/2024

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 School Dist #5 Dicarlo, Rachael D. 3700754176 $1,582.41

Date

Amount

Reissue WT #

Office of the Maricopa County

School Superintendent

District Name / Number: Isaac School District

Contact Name: Tania Valenzuela

= ”

Finance Desk
mum. 20201016

Warrant Void/Stop Request

Attachments:

[| Original Werrant
W| Lost Warrant Affidavit (required for ALL reissues)

Vendor Letter (if requesting Vendor reissue}

Warrant Number Warrant Date | Amount Payee ao} a ©
(starting with “37”) {mm/dd/yyyy) {as it cppeeis in Check Manager) x & 3
3700754176| 4/8/2024 | $ 1,582.41 RACHAEL D. DICARLO ©O

Notes: Check was mailed out to employee on 4/12/2024 but they did not receive it.

District Approver: Tania Valenzuela

Date: 4/26/2024

For Internal Use Only

Clerk of Board Date:

Void Report Date:

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/ Check (dofinitions 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.

RACHAEL D. DICARLO

Name/Claimant

On or about 4/8/2024 (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.

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

Therefore, under penalty of perjury, claimant hereby affirms that this claim is correct
and the amount shown fs due and owing, and the applicant requests that a replacement

warrant/check be issued to him/her In the sum of $1582.41 (3)

Signed: Raw ras AMV (4)

(5) Subscribed and sworn to beforeme this doth day of Ripe al 202.4

CAS

NOTARY PUBLIC ()
My ission expires: No Pee ON ioe
comm : tery Publia-
4/8/2024 Commislon 8 SAz7b4 (seal)

Expires January 34, 2027

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 13700754176

Original Date of Issue
i (if known) (7) Al 8/ 2024

Reason for original issue of Warrant/Check (8);
f— Payroll

C] For Services or Goods furnished
OD Other:

4/30/24
$:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\Schools\Sc
Revised June 2015

4/29/24, 8:35 AM VMware Horizon
Warrant (1 ~ meto) - Warrant number: 3700754176, Stopped

Warrant |
BS] jae |
tals Warrant | Status | Print | Attachments
Maintain New Status | Setup | Attachments __
3700754176
“a Warrant header —_ a oo
General Posting
Warrant number: 3700754176 Invoice:
Holder: invoice date:
Issued date: 4/8/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sentdate: 4/8/2024 12:00:14 pm
Exception flag: UI Agency details
Exception reazon: None Agency veucher number; MAN
Queued for positive pay: {| Agency claim number:
Agency low orig:

Locked forreconcile; | | Agency PO number:
Registered Agency sub fund:
Date registered: Agency dept num: H
No of days interest: 0 i
Annual interest rate: 0,00000

4 Warrant Lines eee ~
(a Amount | Payee Account

& pb | ge | oy | Identification of the warrant

hitps://horizon.maricopa.gov/portalAwebcllent#/desktop. oA