STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MANUEL TORRES.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

Littleton Dist #65 Torres, Manuel 3700665512 $167.20

Date

Amount

Reissue WT #

Office of the Maricopa County Finance Desk

School Superintendent crim 20202016

Warrant Void/Stop Request

District Name / Number: LITTLETON ELEMENTARY SCHOOL Q Attachments:
Contact Name: ANGELICA SUAREZ ] 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 i ee
(starting with “37"} {mm/dd/yyyy) {as it appears in. Check Manager) 2 & B
2
3700665512) 6/29/2023/$ 167.20 MANUEL TORRES © ©
Notes:

District Approver: Romy Date: 3] it | 24

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.
MANUEL, —— (1), being first sworn, upon oath deposes and says:
“Name/Clamant

On or about Lof29 [A 3 (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

aay a issued OO in the sum of $. 167.20 (3)
Signed: aL Za (4)

(5) Subscribed and sworn to before me this waa day of March 20 24,

NOTARY PUBLIC

My commission expires:

Ee brary 01,2025

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

We Check Numbe
arrant/Eheck Number 13700665512

iginal of I
Origina Gate of aa 06/29/2023

Reason for original issue of Warrant/Check (8):
O Payroll

B For Services or Goods furnished, TRAVEL EXPENSE
O Other; TRAVEL EXPENSE

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Schools-Warrants Chec
Revised June 2015 3/11/24

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“AIR VEN VERY ANAEMIA SIRI ASAD

SUMMER MSR ngpe ite fer S ranean

}é

SCHOOL EXPENS 3 70066 12
: seeaper ROF ey county. — cae
PROENIC, ARIZON FROM DATE MARKED "RISUFAICIENT FUNDS" DATE “CONTROL NO.
INYEREST 810PS OW DATE FUNDS AVAILABLE, (SEC 11-036, ARSI056)
wo 06/29/2023 65882621
LITTLETON ELEMENTARY: SCHOOL DISTRICT #65 : .
. i eat WARRANT. AMOUNT: <'
PAY
“One Hundred Suny’ ‘Saven and:20/s00"** Dollars $1 67,20
VOID_AFTER 365 DAYS

THE
ORDER

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NUEL TORRES’. ff is -
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+ EXPENSE: .:

MARICOPA COUNTY SCHOOLS +» PHOENIX, ARIZONA 06/29/2023 Check: 65882621
AP 20230629 3700885512
MANUEL TORRES aa { [_ose/2023 | |
Payee. I | Sheck Date | i
AccountNumber PONumber Invoice Amount -
2 0627-0610 167.20
éf
VOUCHER: 4088 TOTAL: $167.20

WARLANO CLARKE Uz2682 20120012

3/11/24, 2:48 PM

if] aed | \
tn Warrant | Status | Print | Attachments
+

Maintain | New Status | Setup | Attachments

VMware Horizon

3700665512
“a Warrant header ~
General Posting
Warrant number 3700665512] Inveice:
Holder Invoice date:
Issued date: 6/29/2023 12:00:00 am Paid date:
Status: Stepped Positive pay sent date: 6/29/2023 09:00:09 am
Exception Flag: Ul Agency details
Exception reason: None Agency voucher number: 1089
Queted for positive pay: Agency claim number:
_ Agency tow orig:

Locked for reconciles "| Agency PO number:
Registered Agency sub fund;
Date registered: Agency dept num:
No of days interest: °
Annual interest rater 0.00000

4 Warrant Lines
lo Amount ; Payee Account

167.20 MANUEL TORRES

Id do. b> bl | | ) | Identification of the warrant

https://horizon.maricopa.gov/portaldwebclient#idesktop

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