STAMPED & REDACTED - FOR AGENDA ATTACHMENT - SHEPARD INVESTMENT GROUP LLC - 3010170854.PDF

MAR

1COPA
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: 03.01.24

Subject: Affidavit — Shepard Investment Group, LLC

Please find attached one Affidavit for a lost/stolen warrant to be included on the next
available Board Agenda.

e 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 Marcia Bulanda at 506-7291 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: FUND 222 - D220 Human Services - GAX1D 24*12001 - Traylor, Teaira — Rental
Assistance

Application for a Duplicate or Stale-~Dated Warrant/ Check

Affidavit/Claim Form

This application is for: Ea] Duplicate or U stale-Datea (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.

SHEPARD INVESTMENT GROUP, LLC (1)
“= Namercreman’———£-—_—-_-_-____—_””
On or about 14-Jan-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 Jost or destroyed and there is

no reasonable probability of its being found or. presented for payment, er it was not
presented for payment within one year after the date of issuance.

being first swom, Upon oath deposes and says:

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

werent cea to him/her in the sum of $_ 1 12. 7S . _.(3)
Signed 4
gn (" — (4)
Note: Please attach a cépy of the warrant/check if available and/or any other
evidence that a wartant/ originally issued. ——
( tates and s sworn to before me this_| 9° day of % y Wuietwa 202 | .

kr wuiC mi ) A BALEY
Notary Public - State of Arizona |
My OPTI expires: Pnaceiee tc aa
be if Ps ai Expires May 24, eee. (seal)

Warrant/Check Number =

_ (If known) (6,)
Original Date of Issue i 4- J an- -202 4

Reason for original issue of Warrant/Check (8):
OD Payroll
U For Services or Goods furnished,

0 Treasurer’s refund/payment oe
rea} Other; ™ Fund 222 -0220 HUMAN SERVICES - GAX1D 24*12001 - TRAYLOR, TEAIRA - RENTAL ASSISTANCE.

3/7/24

|
|

DESER?

GE

Attention: Marcia Bulanda
Accounting Document Processor

RE:. AFFIDAVIT for lost Check

reissue a replacement warrant
From:
Lina Wharton

Asset Manager

Desert Sage Apartments (Shepard investments)

| Lina Wharton Asset Manager for PEM Management give Christina King Property Manager of
Desert Sage permission to sign affidavit for reissue of warrant/replacement of check numbers
3010770854 11-Jan-2024 and 3010170676 $2040.39 dated 09-Jan-2024. If you have any
questions, please reach out to me or Christina King the Property Manager for Desert Sage
Apartments.

Warm Regards, ,

4,
LINA WHARTON ! ASSET MANAGER f

PEM REAL ESTATE GROUP °

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY

PHOENIX, ARIZONA

One Hundred Twelve And 75/100 Dollars

PAY TO THE ORDER OF
SHEPARD INVESTMENT GROUP, LLC
AT T SAGE

For Questions - 602-506-1379 or emai) AP@MAIL MARICOPA,GOY
MARICOPA COUNTY DEPARTMENT OF FINANCE

DATE
01-11-2024.

Void After
365 Days

WARRANT NUMBER
3010170854

$112.75

AMOUNT

NOT NEGOTIABLE

WARRANT NO. | WARRANT DATE | WARRANT AMOUNT

STMENT GROUP, LLC

3010170854 avn |

INVOICE NUMBER | DESCRIPTION

$112.75

PURCHASE ORDER NO.

VOUCHER NO.

AMOUNT |

INV-0000625439 | TRAYLOR, TEAIRA - UTILITY ASSISTANCE

GAX1D D220
240000012001

240000012001

LL] Agency Status ‘Narrant number

i
5
H

ylormesd |

Issued date

Paid date

Amount

Warrant nuroher: 30to1 70834

Amount» Payee
118.75 SHEPARD INVESTMENT SRCAUP, LLC

Account

Marcia Bulanda (OBF)

From: HSD CCRApayments

Sent: Wednesday, January 31, 2024 8:21 AM

To: FIN AccountsPayable

Ce: HSD CCRApayments

Subject: RE: Affidavit VCO000011207 - Warrant 3010170676 and 3010170854
Categories: Marcia

Hello,

Yes, that is the correct payment address.

Thank you!

Chezly Trinidad

Accounting Specialist

Human Services

Administration Division

234 N. Central Avenue, 3rd Floor Phoenix, AZ 85004

M A R) ¢€ © PA O: 602-372-9748
¢ @) W NTY E: Chezly.Trinidad@maricopa.gov

[ Maricopa.Gov i
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From: FIN AccountsPayable <FiNAccountsPayable@maricopa.gov>

Sent: Tuesday, January 30, 2024 3:27 PM

To: HSD CCRApayments <CCRApayments@maricopa.gov>; FIN AccountsPayable <FINAccountsPayable@maricopa.gov>
Subject: RE: Affidavit VC0000011207 - Warrant 3010170676 and 3010170854

Hello.

_ will start the affidavit process.