STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MARIA DANIELS.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: 05/10/2024 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 My commissign OT OS 0%/ZoZ] 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