STAMPED & REDACTED - FOR AGENDA ATTACHMENT - JAKE SPELLMAN.PDF
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v MAR) COPA COUNTY Office of Budget & Finance 301 W. Jefferson St., 9* Floor Phoenix, Arizona 85003 P: 602-506-3561 F: 602-506-4451 Maricopa.gov To: Clerk of the Board From: Office of Budget & Finance, Accounts Payable Date: 4/5/2024 Subject: Affidavit — Replacement of Lost Warrant Please find attached one Affidavit for a lost warrant to be included on the next available Board Agenda. * The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. e The original warrant is presumed lost. Please call Joyce Maurmann at 506-1343 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor. Thank you. Re: Warrant #3010152945/ JAKE SPELLMAN Fund 675 — D750 GAX1D 230000025583 Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: Duplicate or CI stale-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is page 2 of this form. Jake Spellman (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 13-Jun-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 $2,935.1 1 (3) Signed: hol (4) Y Noté: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. (5)(Subscribed and sworn to before me this 2 day of FFB IC 2024 _. \ 20 LyO- Sea PAVID Wat nee NOWARY PUBLIC ; My commission expires: 475 is Q t- (A-WL SRE Wy as (seal) Warrant/Check Number ani 3010152945 Original Date of Issue aig eS 13-Jun-2023 Reason for original issue of Warrant/Check (8): © Payroll C1 For Services or Goods furnished 0 Treasurer's refund/payment © Other: From: Joyce Maurmann (OBF) To: Clerk Agenda Subject: RE: 3010152945 Jake Spellman Date: Tuesday, April 9, 2024 11:23:25 AM Attachments: image001.pna Hi Dorene, It is an settlement payment from Risk Management. thanks, Joyce Maurmann Accounting Document Processor Budget & Finance 301 W Jefferson St, 9th floor Phoenix, az 85003 v MARICOPA =:: county Ailes Facebook | Instagram | Twitter | YouTube | Linkedin From: Clerk Ager Sent: Tuesday, April 9, 2024 11:16 AM To: Joyce Maurmann (8 Subject: RE: 3010152945 Jake Spellman Good morning Joyce, Is this affidavit for victims compensation? It’s just marked other on the warrant. Dorene Tremayne Management Analyst Clerk of the Board 301 W. Jefferson 10th Floor Phoenix, Arizona 85003 V Facebook | Instagram | Twitter | YouTube | Linkedin From: Joyce Maurmann (08) Sent: Friday, April 5, 2024 2:26 PM To: Clerk Agenda [nn Dorene Tremayne (COB) Subject: FW: 3010152945 Jake Spellman Hello, Attached is affidavit for requesting a replacement warrant. Thanks, Joyce Maurmann Accounting Document Processor Budget & Finance v MARI|ICOPA COUNTY | | oe | From: jake Spel 2 Sent: Tuesday, April 2, 2024 5:44 PM To: Joyce Maurmann (8° Subject: 3010152945 Jake Spellman This Message Is From an Untrusted Sender You have not previously corresponded with this sender. Please use caution when you receive messages from new senders. Always validate the sender first. Attached is the signed and notarized form that you sent to me. : new _ address is: Thank you very much.