STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MARIA DANIELS.PDF

Maricopa County — Formal (2024-05-22)

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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: 05/10/2024

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

Avondale Elementary 44 _| Daniels, Maria Laylin 3700654702 $1464.37

Application for a Duplicate or Stale-Dated Warrant/ Check

Affidavit/Claim Form

This application is for: | Duplicate or C state-Dated (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.
Danicts, Malla Laylin (1), being first sworn, upon oath deposes and says:
On or about 5/26/2023 (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 be issued to him/her in the sum of $1,464.37 (3)
Signed: iY Subic. euibo—> (4)

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

(5) ait gle. this A day of Mad 2027

NOTARY PUBLIC —«_—_iiitiCiCi«ét lille ln

Christopher Arrellin Lugo

. Notary Public

-) Maricopa County, Arizona

tf My Comm. Expires 05-08-27

Commission No. 649525 (seal)
satin atientiinel

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Warrant/Check Number
(if known) (6) 3700654702

Original Date of Issue
(known) (7) 5/26/2023

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

O For Services or Goods furnished
5/10/24

O Treasurer's refund/payment
O Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Warrants Checks notice €. ~-0..  --e4----
Revised April 2015 A.R.S, 11-632 & 11-644

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent ram 20201016

Warrant Void/Stop Request
District Name / Number: AVONDALE #44

Attachments:
Contact Name: McWilliams, Noemi [] Original Warrant

Contact e-mail: Po Lost Warrant Affidavit (required for ALL reissues)

[| Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee x= 2
(starting with “37”) (mm/dd/yyyy) (as it appears in Check Manager) g 2
3700654702 5/26/23 $1,464.37 DANIELS, MARIA LAYLIN

©
O

[ ] [] LC] [s] Re-issue

Notes: Employee lost the warrant, please reissue

District Approver: Noemi McWilliams Date: 5/40/2024
For Internal Use Only
Clerk of Board Date: Void Report Date:

ox

Warrant Status | Print Attachments

v

Maintain New Status Setup Attachments

Warrant (1 - mcto) - Warrant number: 3700654702, Stopped, Status: Stopped

3700654702

+ Warrant header
General
Warrant number:
Holder:

Issued date:

5/26/2023
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

12:00:00 am

Posting

Invoice:

Invoice date:

Paid date:

Positive pay sent date:

Agency details
Agency voucher number: 45
Agency claim number:
Agency low orig:

Agency PO number:

Agency sub fund:

Agency dept num:

5/25/2023

09:00:19 am

4 Warrant Lines

im Amount Payee

1,464.37 DANIELS, MARIA LAYLIN

> pi | vA | 9) | Identification of the warrant