STAMPED & REDACTED - FOR AGENDA ATTACHMENT - AAJHSC.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: 03/11/2024

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

Wickenburg Dist #9 AAJHSC 3700653690 | $1,200.00

Date.

Amount

Relssue WT #

Office of the Maricopa County Finance Desk

School Superintendent mm 20201016

Warrant Void/Stop Request

District Name / Number: Wickenburg Unified School District #9 | Attachments:

Contact Name: Lisa Smith [| Original Warrent

|
Contact e-mail Po | Lost Warrant Affidavit (required for ALL reissues)
}
| [] Vendor Letter {if requesting Vendor reissue)

Warrant Number Warrant Date ..| Amount Payee B22. %e
{starting with 37") (mm/del/yyyy) [as it appecrs in Check Manciger] Ka FS z
3700653690| 5/23/2023 '$ 1,200.00 AAJHSC © OU)

Notes: | OST CHECK, PLEASE VOID

J f LA? x
District Approves] OTL Date: 3/44/2024
<

For Internal Use Only
Clerk of Board Date: Yoid 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.

Susin Hall (AAJHSC)___(1), being first swom, upon oath deposes and says:
—NamerCramant

On or about 9/23/2023 (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 daim 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 "a of ¢ 1200.00 3)

Signed: Soa Lpn i

(5) Subscribed and sworn to before me this Z@* day of March 2094,

nycse utbaid

(4)

‘'Y PUBLIC
Te CQatabar 2Oo$ Pata So Southard (seal)
‘eaten Expires 9/14/2025

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

Warrant/Check Number 13799653690 / 9619941
Original Date of Issue

pate of Is {05/23/2023
Reason for original issue of Warrant/Check (8):
O Payroll

CO For Services or Goods furnished AAJHSC State Convention Fees
f Other; AAJHSC State Convention Fees

S:\PROCESSES\Warrants ~ Duplicate or State\02 Forms\Schooks\Schools-Warrants Che 3/29/24
Revised June 2015 /

SAMIZONA NSSOLLATION
OF JUNIOR HC

HLS

Friday, March 8, 2024

To whom it may concern:

Susin Hall is an authorized signer of Arizona Association of Junior High Student Councils as she

is the acting President of the Association. Please let us know if you need additional information
to process the affidavit,

y

Laura Johnson
Vice President

AAJHSC

3/11/24, 9:07 AM VMware Horizon
Warrant (1 ~ mcto) - Warrant number: 3700653690, Stopped

7 | Warrant |
VS Kile | ff} as
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talit Warrant | Status | Print | Attachments
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Maintain New Status | Setup | Attachments
3700653690
“aWarantheader sStS™~S~S 7 :
General Posting
Warrant number: 3700653690) Invoice:
Holder invoice date:
Issued clate: 5/23/2023 42:00:00 am Paid clate;
Status: Stopped Positive pay sent clate: 5/24/2023 09:00:29 am
: ion flag:
Pcepion ag I | Agency details
“ception ‘sezen None Agericy voucher number; 2379
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 clays interest: 0

Annual interest rate: 0.00000

4 Warrant Lines
!

Ey): Amount Payee | Account

be bl | a | py | Identification of the warrant

htlps://horizon.maricopa.gov/portal/webclient/#idesktop 1h

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