STAMPED & REDACTED - FOR AGENDA ATTACHMENT - KEVIN SAKALAS.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: 04/25/2024

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

Balsz Dist #31 Sakalas, Kevin 3700720199 $243.75

MCESA Stop/Cancel/Void Form

Maricopa County

School District Balsz Elementary School Dist.

Education Service Agency Attachments: — [~ Original Warrant
District #: 31 & Affidavit
[~ Void Report
Voucher Number |2426 [~ Other

Pre Printed MICR Number
Fund (always begins with a"4" or a"1") Amount Warrant Date System Generated Warrant # Payee

[46 243.75 [12/12/2023 [3700720199 |Kevin M Sakalas

| |
|
|

| |
| | | |
| | |
|

Reason for Stop, Cancel or Void: |” Check here if to be reissued by MCESA

Original warrant lost in us mail, please stop and re-issue

“4

Prepared By: Erika Alonzo Date |04/25/2024

Approved By: |Erika Alonzo Date: |04/25/2024
StopCancelReleaseForm.pdf alcd

11/14/11

‘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.
Revit, M Saka las (1), being first sworn, upon oath deposes and says:

Name/Claimant

On or about eeamber, 12,202 SF caay2) 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

vere) Ore im/her in the sum of ¢_24B-7S _ 3)
i
Signed: ols A (4)

7X
(5) Subscribed and sworn to before me this Ci day of Apr | 20QU.
'Y PUBLIC = MIRIAM DELGADO
SEX\ NOTARY PUBLIC
My commission expires: ‘ Gk): STATE OF TEXAS
Oi Oos lacs SE 24/ Nv COMM. EXP. 0105/27 (seal)
NGTARY ID 12848254-1

Note. Please attach a copy of the warrant/check if available and/or any other
evidence that a warrant/check was originally issued.

Merman | 3100720199

| Original Date of Issue KS
a tinown) izliclzozs
Reason for original issue of Warrant/Check (8):
0 Payroll

x For Services or Goods furnished
O Other:

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

4/26/24, 7:21 AM

Warrant (1 - mcto) - Warrant number: 3700720199, Stopped

VMware Horizon

2K vi. ry
; {=| ay E
Warrant Status Print Attachments
Maintain New Status Setup | Attachments
3700720199

“4 Warrant header
General

Warrant number:
Holder:
Issued date:

12/12/2023
Status: Stopped
Exception flag:

Exception reason: None

Queued for positive pay:

Locked for reconcile:

Registered

Date registered:

No of days interest: 0
Annual interest rate: 0.00000

4 Warrant Lines
oO Amount Payee
243.75 Kevin Michael Sakalas

12:00:00 am

Posting
Invoice:
Invoice date:
Paid date:

Positive pay sent date: 12/13/2023

Agency details

Agency voucher number: 2426
Agency claim number:
Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept num:

Account

09:00:15 am

Id <r bm Pl |

https://horizon.maricopa.gov/portalAvebclient/#/desktop

’ | & | Identification of the warrant

Ww