STAMPED & REDACTED - FOR AGENDA ATTACHMENT -3700741509 - 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 3700741509 $73.11

Date

Amount

Relssue WT #

Office of the Maricopa County

School Superintendent

District Nome / Number: SMUSD 90

Contact Name: Crystal Mondragon

Commas eats Be oan oe — —
| Vendor Letter (if requesting Vendor reissue)

Finance Desk
mn 20261016

Warrant Void/Stop Request

Attachments:
C] Originel Warrant

Warrant Number
(eorting with “377)

Warront Date
(am/dd/ryry)

Amount

Payee
(os @ oppeors in Check Manager)

Vold
Stop
Re-Issue

'3700741509

2/28/2024

$73.11 IMMANUEL, THOTH ‘@x0)

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

District Approver:

. Date: 5/3/2024

Clerk of Bourd Date:

Far Internal Use Only

ae

™

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.

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

On or about heb 78, 20H (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

ef to him/her in the sum of $73.1 1 (3)

Signed: (4)

(5) Subscribed and sworn to before me this 3 day of Manu

-

NOTARY PUBLIC

My commission expires:
pp gu. wo hy lon

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

Warrant/Check Number “13790741509

Original Date of Issue
i GE known) (7) 2/28/2024

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

For Services or Goods furnished REIMBURSEMENT
Cl Other; REIMBURSEMENT

S:\PROCESSES\Warrants ~ Duplicate or Stale\02 Forms\Sehr
Revised June 2015

5/3/24

5/3/24, 3:10 PM VMware Horizon
Warrant (1 - meto) - Warrant number: 3700741509, Stopped

OM tah Fe | i7 y
roti Warrant | Status | Print | Attachments
¥
Maintain New Status | Setup | Attachments
3700741509
~~ Warrantheader —

General Posting
Warrant number: 3700741509) Invoice:
Holder; Invoice date:
Issued date: 2/28/2024 42:00:00 am Paid date:
Status: Stopped Positive pay sent date: 2429/2024 09:01:01 am
ection flag: i Agency details

ception reason’ None Agency voucher number, 2471
Queued for positive pay: lv} Agency claim number:

Agency low orig:
Locked forreconcile: {| Agency PO number
Registered Agency sub fund:
Date registered; Agency dept num;
No of clays interest: 0
Annual interest rate: 0,00000
4 Warrant Lines
Cc Amount | Payee Account

“ven fF

4 ic B® PL | & | 9) | tdeatification of the warrant

https://horizon.maricopa.gov/portal/wabctient/#/desktop