STAMPED & REDACTED - FOR AGENDA ATTACHMENT - 3700746079 - THOTH IMMANUEL.PDF
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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 3700746079 $64.63 Office of the Maricopa County School Superintendent Finance Desk men 20281016 Warrant Void/Stop Request District Name / Number: SMUSD 90 Contact Name: Crystal Mondragon Attachments: C] Original Worrant Lost Werrant Affidavit (required for ALL reissues} CJ Vendor Letter (if requesting Vendor reissue) Date Werrant Number Worrent Date | Amount (Porting with "37") (om/de/rerr) Payee (es & appeors it Check Manager} Vold Stop Re-Issue Amount 3700746079} 3/13/20 | $64.63 Notes: Checks were being sant ta the wrong home address. IMMANUEL, THOTH oO © S District Approver:, ~ Date: 5/73/9024 a For Internal Use Cry ae” ™, Clerk of Board Date: Void Report Date: Relusue WT # 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: Nameé/Claimant On or about (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 ay him/her In the sum of ¢$64.63 (3) Signed: Ahh (4) (5) Subscribed and sworn to before me this 3 dayot Many 20_244 Seta "Webbe NOTARY PUBLIC My commission expires: LO } 14 12.09-9 OES me Note. Please attach a copy of the warrant/check if availatienancror any other evidence that a warrant/check was originally issued. Warrant/check Number 13700746079 Original Date of I riginal Date of | issue 3 i 3/2024 Reason for original issue of Warrant/Check (8): ] Payroll For Services ot Goods furnished REIMBURSEMENT O Other; REIMBURSEMENT S:\PROCESSES\Warrants ~ Duplicate or Stale\02. Forms\Schools\Sche Revised June 2015 j 5/3/24 5/3/24, 3:09 PM Warrant (1 - mcto) - Warrant number; 3700746079, Stopped || Warrant | VMware Horizon SR Dh te | i 7 a ae tehi Warrant | Status | Print ¥ Maintain New Status | Setup 3700746079 “a Warrant header ee _ —_ General Posting Warrant number: 3700746079) Invoice: Halder: Invoice date: jsstied date: 3/13/2024 Paid date: Status: Stopped Positive pay sentdate: 3/14/2024 09:00:34 am acin flag: | Agency details ‘ception reason: None Agency voucher number: 2475 Queued for positive pay: |»"| Agency claim number: Agency low orig: Locked for reconcile: | Agency PO number: Registered Agency sub fund: Date registered: Agency dept num: No of days interest: 0 Annual interest rates ©,00000 o Amount | Payee ' Account 64.63 IMMANUEL, THOTH Iq di Bm BL 7 | 19) | identification of the warrant https://horizon.maricopa.gov/portal/webclient/#/desktop 1 1 i