STAMPED & REDACTED - FOR AGENDA ATTACHMENT - KIERRA YVONNE ORABUENA.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: 03/27/2024

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

Litchfield Dist #79 Orabuena, Kierra Yvonne 3700744487 $444.80

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent mm 20201016

Warrant Void/Stop Request

District Name / Number: Lidchfield Elem. School Dist. #79 Attachments:
Contact Name: Eli zabela Thomas [| Original Warrant

Contact a 60Ultti(i‘COSCSC‘*d K] Lost Warrant Affidavit (required for ALL reissues)

[| Vendor Letter (if requesting Vendor reissue)

Warrant Number Warrant Date | Amount Payee xe] a/ow
(starting with “37") (mm/dd/yyyy) (as it appears in Check Menager) ‘oO 2 2
Sua es
)
a
3700744437 | B/rf2or4| 444.90 Ki erra YWonne Orabuena © © [Xx]
|

Notes: A ()
sa
District Approver: Chub faemayy Date: 3/2u/ay

For Internal Use Only

Clerk of Board Date: 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.

k terra Yvonne, Or abue ng (1), being first sworn, upon oath deposes and says:

On or about _ 37 12/ 2024 (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 $. 444. BO (3)

sionet: Ge 7 Gee — (4)

(5) Subscribed and sworn to before me this Q(o day of Ydar@h _209¢/ .

NOT, au PUBLIC

oa ; BRI CART!
My commission expires: Nel Pubs mre
. i a a laricopa C,
M5' _coaricopa (seal)
My Comm. peak

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

(if known) (6) | 37007 4437
orginal) ye | 2 [20
Reason for original issue of Warrant/Check (8):

Payroll
O) For Services or Goods furnished
O Other:

3/29/24

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schoois\Schools- 5
Revised June 2015

3/27/24, 2:50 PM VMware Horizon

Warrant (1 - meto) - Warrant number: 3700744487, Stopped

Warrant

J
Warrant Status Print Attachments

¥
Maintain New Status Setup Attachments 1h
3700744487
4 Warrantheader
General Posting
Warrant number: 370074448 Invoice:
Holder: Invoice date:
Issued date: 3/12/2024 12:00:00 am Paid date:
Status: Stopped Positive pay sent date: 3/8/2024 09:00:10 am
Exception flag: Agency details
Exception reason: None

Agency voucher number: 21
Queued for positive pay: Agency claim number:
Agency low orig:
Locked for reconcile:

Registered

Agency PO number:
Agency sub fund:
Date registered:

No of days interest: 0
Annual interest rate: 0.00000

Agency dept num:

4 Warrant Lines

o Amount Payee

444,80 Orabuena, Kierra Yvonne

Account

ld <4 Pm Pl | 7 | &) | Identification of the warrant

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