STAMPED & REDACTED - FOR AGENDA ATTACHMENT - MARIE M LEMMON.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: 02/14/2024

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

Roosevelt Dist #66 Lemmon, Marie M 3700720294 | $10,617.50

Office of the Maricopa County Finance Desk
School Superintendent mm 20201016

Warrant Void/Stop Request

- District Name / Number: Roosevelt School District #66 Attachments:

Contact Name: Ashley Garcia EC] Original Warrant

Lj Vendor Letter (if requesting Vendor reissue)

3700720294 12/12/2023] $ 10,617.50 Marie M. Lemmon

: Notes: /
“--vL* District Approver: Date: 2\— | 2ezey ¥
5. | ForInternal Use Onty
‘ oe Clerk of Board Date: Void Report Date:
Bo
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"3700720294.

SCHOOL EXPENSE WARRANT

L
Y's aed TREASURER OF MARICOPA COUNTY
ARIZONA PHOENIX, ARIZONA. 91-2221 DATE CONTROL NO.
42/12/2023 66921647
Roosevelt School District No.66
| WARRANT AMOUNT
PAY .
“Ten Thousand Six Hundred Seventeen and 50/100** Dollars | $10,617.50

VOID AFTER 365 DAYS

ro MARIE M, LEMMON I

ORDER °
oF superintendent PESO SIGNATURES

, 12/12/2023 Check: 66921647 EXPENSE
MARICOPA COUNTY SCHOOLS + PHOENIX, ARIZONA ___ AP 20231213 ; __ 3700720284

MARIE M, LEMMON | ee | 12/2/2023 |
Payee if | Check Date |
Account Number PO Number Invoice Amount

wIsiast 20230018 5208748
FAAstsi1 2923002 520875

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VOUCHER: 2054 TOTAL: $10,617.50

HARLAMO CLARKE 4122732 30106562

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/Check (definitions are on pago 2) -

STATE OF ARIZONA Note: Numbers on this form cortespond to numbers on the
COUNTY OF MARICOPA Instruction sheet which is page 2 of this form.
<

1), being first sworn, upon oath deposes and says;

On or about Dec. | >* (dore)(2) a warrant/check was issued to the
above named person/entity in the amount as stated below. Such warrant/check was
elther never received or was subsequently Inadvertently lost or destrayed 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, clalmant hereby affirms that this claim is correct
and the amount shown Is due and owing, and the applicant requests that 8 replacement

watrant/check be | to him/her ip the sum of s_10,6/7-0
Signed: "Wie ob

(5) Subscribed and sworn to before me this _Q__day of __F7e uasrasu20_ 2.44
NOTARY PUBLIC ‘Commonweakh of Vir;

Notary Public
, Commission No. 7948340

My comm expires: ‘My Comission Expires 3012025
(seal)

Warrant/Check Number ‘) 00 0) waa Leen

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

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SAPROCESSES\Warrants - Dupticata or Stale\02 Forms\Sdwals\Schocls Warrants Choos notice ef daimdoc
Revised June 20 18-999

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Shi Warrant | Status | Print | Attachments

VMware Horizon

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Maintain New Status | Setup | Attachments
3700720294
4 Warrant header a ”
General Posting
Warrant number: 3700720294) Invoice:
Holder: Invoice dates
issued date: 12/12/2023 12:00:00 am Paid dates
Status: Stopped Positive pay sent date; = 12/13/2023 09;00;}5 am
Exception flag: Vt Agency details
Exception reasom None

Queued for positive pay: )“]

Locked forreconcile, [|
Registered

Date registered:
No of days interest: 0
Annual interest rate: 0.00000

4 Warrant Lines

im] Amount Payee
10,617.50 MARIE M. LEMMON

Agency voucher number: 2054
Agency claim numben

Agency iow orig:

Agency PO number

Agency sub fund:

Agency dept num:

Account

lq do. » BI | ra | Pp) | identification of the warrant

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