REDACTED - FOR AGENDA ATTACHMENT - JENNIFER BARTOLOMEO.PDF

v
MARICOPA
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: 3/13/2024

Subject: Affidavit — Replacement of stale dated warrant

Please find attached one Affidavit for a stale dated 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 and is stale dated.

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 #3010134203 / Jennifer C Bartolomeo
Fund 716 ~ D190 GAX1D 230000010321

Application for a Duplicate or Stale-Dated Warrant/ Check
Affidavit/Claim Form

This application is for: [1 Duplicate or [4] State-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
paae 2 of this form.

Jennifer C. bar tolomes(), being first sworn, upon oath deposes and says:

Name/Claimant

On or about 2-27-24 (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, gr 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

ane, be issued to him/her in the sum of $1, 750.00 .(3)
Signed: _/ ud, iG Prcthel : old 2 (4)
Note: e ateddh @ copy of the wartant/check if available and/or any other

evidence that a warrant/check was originally issued.

(5) Subscribed and sworn to before me this ot = day of Wrsrtk 20 a4.

FM HATH wt LLEFORD L

: Ge Notary Pablfe - Maricopa County &
A) Commission Ne. 609496 A

‘ ; gy Commission Expires

April 30, 2025

NOTARY PUBLIC

My commission expires:
4 [301,05

Wi t/Check Numb
arrant/Check Number 13010134203

Orginal Date of Issie@ 47. Noy-2022 |

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

O Payroll

C1 For Services or Goods furnished

(1 Treasurer’s refund/payment
Other: FDP-Restitution

COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY WARRANT NUMBER
3010134203

PHOENIX, ARIZONA

DATE
11-17-2022 91-2/1221

One Thousand Seven Hundred Fifty And 00/100 Dollars
$1,750.00

AMOUNT

PAY TO THE ORDER OF
JENNIFER CHAVEZ

Void After
365 Days

For Questions - 602-506-1379 or email AP@MAIL.MARICOPA.GOV
MARICOPA COUNTY DEPARTMENT OF FINANCE

NOT NEGOTIABLE

RETAIN THIS FOR | PAYEE WARRANT NO. | WARRANT DATE | WARRANT AMOUNT

YOUR RECORDS
VICTIM WITNESS 3010134203 11/17/2022 $1,750.00
INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT
GAX1D D190 230000010321 1,750.00}CA

CR2022-109323-001-| FDP - JOSEPH CHAVEZ
230000010321

3/4/24

To whom it may concern:

Dear Anu,

My home was vandalized and the restitution check for the damages never arrived, even though the
diversion program was completed last year. | made countless attempts to email and call my victims
advocate as well as the county, with no success. Finaly after over a year of trying to get my restitution
check, | received an affidavit in the mail to resolve the case. As you can imagine, | am very thankful for
the help after so much time has passed.

| changed my address with the county last year, and also am married now. My maiden name was Jennifer
C. Chavez, but my married name is Jennifer C. Bartolomeo. | am including the email correspondence
letters that were most recently exchanged in attempt to correct matters. | have also included a copy of
my drivers license that shows my updated last name. | put a copy of the original diversion plan
completion information from the county attorney.

{ look forward to hearing that the check is on the way so! can put this behind me, as it has dragged on
unfairly for a very lengthy amount of time. | appreciate your help in closing this case. Please let me know
that you are receiving the documentation and if you need anything else. | am sending it certified mail,
however, want to be sure it gets to the correct person.

DES bot

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