STAMPED & REDACTED - FOR AGENDA ATTACHMENT - LUIS R VALENTINO.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: 02/22/2024

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

Isaac School Dist #5 Valentino, Luis R 3700644551 $3,150.00

Stop/Cancel/Void Form

School District \SQac Sch Dist Maricopa County
Educatio. ice Agency Attachments: [~ Original Warrant
District #: ds ° Affidavit
—_— — J~ Void Report

Voucher Number AI) Rother

Fund Pre Printed MICR Number Amount Warrant Date System Generated Warrant # Payee
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(OUD =| S60CGTSS1 3150.00 [4-D-33 INGEe Wallenfing, Cars. 2,

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Reason for Stop, Cancel or Void: Check here if to be reissued by MCESA

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Original warrant Wes list in the wail

Prepared By:
Print Form _f

Date

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Approved By:
StopCancelReleaseForm.pdf alcd

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Date:

Schools Affidavit/Claim Form

Application for a Duplicate Warrant/ Check (definitions are on page 2) _

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

Luis K. Valenti ne (1), being first sworn, upon oath deposes and says:

On or about Apul 2.2023 (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
ho 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

warrant/chec ee porn oe of $3 (S0.00 (3)
Signedy=z Poche (4)

(5) Subse and sworn to before me this \\*" __day of August 20.27.

one PUBLIC
ys, DAVID ACEVEOO-RAMIREZ
WO rahe County California
My commission expires: { a
Oct 27, FOIE: ‘ay Conn, tenes 027.2026 (seal)

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

Warrant/Check Number .
(if knowin) (6) 22-O0(UUBSI
Original Date of Issue
(if known) (7) Apr { 9),9093
Reason for original issue of Warrant/Check (8):
Payroll
& For Services or Goods furnished Saue es
OO Other: _ _—
SAPROCESSES\Warrants - Duplicate or Stale\02 Forms\Schools\Scl 2/22/2024

2/46/24, 10:54 AM
7 Warrant (1 - mcto) - Warrant number: 3700844851, Stopped

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Attachments

VMware Horizon

ibe Warrant | Status | Print
Maintain New Status | Setup | Attachments
3700644851
4 Warrant header a
General Posting
Warrant number Invoice:
Holder: Invoice date:
Issued date: 4/27/2023 12:00:00 am Paid date:
Status; Stopped Positive pay sent date; 4428/2023 12:00:04 pm
ti 3
Exception flag f | Agency detalts
Exception reason: None

Queued for positive pay: {//

Locked forseconcile: | |

Agency voucher numben 4197
Agency claim number:

Agency low arig:

Agency PO number:

Registered Agency sub fund:

Date registered: Agency dept num:

No of days interest: 0

Annual interest rates 0,00000 |
4 Warrant Lines

O Amount . Payee Account

3,150.00 VALENTINO, LUIS R.

Iq qi be Pl | a | a | Identification of the watrant

https://horizon.maricopa.gov/portalAvebcllent/#/desktop

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