STAMPED & REDACTED - FOR AGENDA ATTACHMENT -3700733580 - THOTH IMMANUEL.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: 05/03/2024

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

Saddle Mtn Dist 90 Immanuel, Thoth 3700733580 $223.90

Date

Amoynt

Relsue WT #

Office of the Maricopa County

School Superintendent

District Name / Number: SMUSD 90

Contact Name: Crystal Mondragon

Cone <n ten Woman Aion earns to AN eee

Finance Desk
men 20281016

Warrant Void/Stop Request

Attachments:
CL] Original Warront

| Vendor Letter (if requesting Vendor reissue}

Warrant Number Worrant Date | Amount Payee = a2
{erting with “377) (tom/dd/yryy) (os it oppeors ie Check Manager} 2 FS z
13700733580) 1/31/2024 | $ 223.90 IMMANUEL, THOTH 0O®

Notes: Checks were being sent to the wrong home address.

District Approver:

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~ Date: 5/3/2024

Clerk of Board Date:

Far Internal Use Gay

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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 sheel which is page 2 of this form.
IMMANUEL, THOTH (1), being first sworn, upon oath deposes and says:

Name/Cralmant

On or eee pac 21 opp ( (date)(2) a warrant/check was issued to the
person/ent

above named 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.isfyed to him/her in the sum of $223.90 (3)

Signed: Ll {4)

(5) Subscribed and sworn to before me this 3 day of May 202.

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NOWARY PUBLIC So es

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Note: Please attach a copy of the warrant/check If available “ny any other

evidence that a warrant/check was originally issued,

Warrant/chec Number "13700733580

Original Date of Issue /
gina (tinaun) 0) 1/31/2024

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

For Services or Goods furnished REIMBURSEMENT
+) Other: REIMBURSEMENT

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schoo!s\:
Revised June 2015

5/3/24

5/3/24, 3:10 PM
Warrant (1 - mcto} - Warrant number: 3700733580, Stopped

VMware Horizon

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Sal Warrant | Status | Print | Attachments
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Maintain New Status | Setup | Attachments
3700733580

“a Warrantheader
General Posting
Warrant number: 13700733580 Invoice:
Holder: Invoice date;
Issued date: 1/31/2024 12:00:00 am Paid date:
Status; Stopped Positive pay sent dete: 2/1/2024 09:00:07 am
Exception flag: tt Agency details
Exception reason: None Agency voucher number: 2463
Queued for positive pay: {.} Agency claim number

Agericy low orig:

Locked forreconcile |__| Agency PO number
Registered Agency sub fand:
Date registered: Agency dept num:
No of days interest: 0
Annual interest rate: 0,00000

“a Warrant Lines ;
O Amount : Payee : Account

223,90 IMMANUEL, THOTH
lq @ois »& bl | P | f) | Identification of the warrant

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

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