REDACTED - FOR AGENDA ATTACHMENT - DANIEL H. SAYLOR_MARIA L. SAYLOR_REDACTED.PDF

v
MARICOPA COUNTY

TREASURER’S OFFICE

John M. Allen, Treasurer
301 West Jefferson St., Rm. 100
Phoenix, Arizona 85003

Phone: (602) 506-8511

Fax: (602) 506-1102
http://treasurer.maricopa.gov

To: Clerk of the Board
clerk.agenda@maricopa.gov
Dorene.Stretar@Maricopa.Gov

From: Treasurer’s Office

Maria Quitangon ye
maria.quitangon@maricopa.gov

602-506-1958

Cathy Sanchez
cathy.sanchez@maricopa.gov
602-506-7881

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No
Daniel H Saylor 946859 299.43 | Treasurer

Maria L Saylor

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

This application is for: O Duplicate or [Stale-ated (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.

Denwzee bw 5 hepo& (1), being first sworn, upon oath deposes and says:
Name/Claimant

On or about & \3/ Wee (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

warrant/check Troe to him/her in the sum of $__Z. q a. 4 2 .(3)
(4)

Signed:

Print name: (required) ee by. Dor

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

. jaeematsaibed and sworn to before me this S

NOTARY PUBLIC

My (That n expires:
QT[1OLS

heck Numb
Warrant/Check van er Q Uy Le & 54

Original Date of Issue

(it known) (7) $ [3 / Loz
Reason for original issue of Warrant/Check (8):

O Payroll

O For Services or Goods furnished
(Treasurer's refund/payment

O Other:

S:\PROCESSES\Warrants - Duplicate or Stale\02 Forms\Current Claim Form\100518 Warrants Checks notice of claim.doc
Revised 100518 A.R.S. 11-632 & 11-644

Maricopa County Treasurer's Office

304-22-235 7 12/12/2023 11:45:35 AM

[BB 304-22-235 7 - x
File Help .
Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Ac “a
2023. TAX PAYMENT 2023-11-30 = 052-73131 $1566.16 2023-11-29 F 6:2
2023 TAX BILL 2023-08-26 Y 12:
2022 TAX PAYMENT 2022-12-06  052-94456 $1516.50 2022-11-30 -F &:5
2022) TAX BILL 2022-08-20 v 12
N
RES REFUND LETTER 2022-08-02 N
2021 RES IMPOUND 2022-08-02 AS -07314 $299.43 N
2021 TAX PAYMENT 2022-08-02 AS -07314 $1,602.28 N 2021-12-15  F
2021 «POST NEW TAX (RESOLUTION) 2022-08-02 AS -07314 $1,602.28 N Biv
< >
Parcel #: [304-22-235 Activity: [REFUND Act Date:/08/03/22
Tax Year: [2021 Tran #[- fe] Act Time 12.00 AM

Activity Detail | Address Detail |

CP #: jo
Buyer #: jo
Fund: [26

Click icon for Disbursements Inquiry. ----->

Check Date: [09/03/22
Check #: [946859
Refund Amount: | $299.43

View Image... Close

Maricopa County Treasurer’

AM

s Office

Refund ID 2022016586 RESOLUTION

File Help

EI}

& Refund ID 2022016586 RESOLUTION

“Refund Amount [$299.43

|

Requester: [RESOLUTIONS on 8/2/2022

| Refund Reason: [Resolution has reduced taxes

Status: [DISBURSED on 8/2/2022

Slip ID: |202200558

Address: = DANIEL H SAYLOR

Impounds | Stub | Comments |

Check Request: JRESO DESK

Reference #: |RES #07314

Impound #1

Amount | Tax Year | Status

$299.43 2021 READ

Parcel/Roll :|304-22-235 Dest fund : (026

cen: 0 Reso: [7314

CP buyer # :|0 Phase tt: [129

Mortgage code: |

Transaction #: [RS 07314

| {Source Fund { Linked |
| | 033 True
|

Impound Total : 1

Case #: j

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