REDACTED - FOR AGENDA ATTACHMENT- RAUL LOPZ JR_941945.PDF

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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 ye
Maria Quitangon
maria.quitangon@maricopa.gov
602-506-1958

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

Re: Stale Dated Warrant

Name Warrant Amount | Dept/School
No
Raul Lopez Jr. 941945 $93.39 | Treasurer

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

This application is for: Oo Duplicate or [X] stale-Dated (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.
RAUL Lofég NIA (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about (PAIL 13 AoA) (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 be issued to him/her in the sum of $ A3.3 4 .(3)
Signed: Qual e | pad (4)

Print name: (required) RWL Lofez te

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

(5) Subscribed and sworn to before me this als day of Och\ouw_ 20.23.

NOTARY PyBLIC ’

My commission expires:

2 Pe) (seal)
| Warrant/Check Number
(if known) (6) a | 4\ a 4S
Original Date of Issue
(if known) (7) APRIL 13 AOsAR

O Payroll

O For Services or Goods furnished

§@ Treasurer’s refund/payment

O Other:

S:\PROCESSES\Warrants - Duplicate o|
Revised 100518

s\Current Claim Form\100518 Warrants Checks notice of claim.doc

RECEIVED ARS. 11-632&11-644 | €V

yer st
\\

OCT 31 2023

MAP*COPA COUNTY

Maricopa County Treasurer's Office 102-77-217 2 11/1/2023 10:25:39 AM

FBR 102-7-217 2 _ x
File Help
Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act a
2023 TAX BILL 2023-08-26 Y 12:(
2022 TAX PAYMENT 2023-04-25 MO -F401 $470.53 N 2023-04-24 F 8:08
2022 TAX PAYMENT 2022-10-25 MO -F401 $470.53 N 2022-10-25 1 7:58
2022 = INFO STATEMENT 2022-08-20 Y 12:(
2022 TAX BILL 2022-08-20 Y 12:
2021 REFUND 2022-04-13 - $90.86 N 12:(
2020 REFUND 2022-04-13 . $86.96 N 12:
2019 REFUND 2022-04-13 : $97.79 N 12:(
REFUND 2022-04-13 Z N ¥
< >
Parcel #: 1102-77-21? Activity: REFUND Act Date}04/13/22
Tax Year: [2078 Tran #: [- (| Act Time {12:00 AM

Activity Detail | Address Detail |

CP #: oc © Check Date: Jo4713722
Buyer: [J Check #: [941945
Fund: se  — Refund Amount: $93.39

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

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Maricopa County Treasurer's Office Refund ID 2022008422 RESOLUTION 11/1/2023 10:25:49
AM

&. Refund ID 2022008422 RESOLUTION - Oo x
File Help a _ :
SIR
RefundAmount: [$9339 Requester; [RESOLUTIONS on 4/12/2022
Refund Reason: Re ‘olution has reduced taxes Status: [DISBURSED on 4/12/2022
Slip ip: 202200243
Address: Check Request: JRESO DESK

Reference #: |RES #18571

Impounds | Stub | Comments |

Impound #1
Source Fund | Linked | Amount | Tax Year_| Status Parcel/Roll:[102-77-217 Dest fund : 1026
033 True $93.39 2018 READY CP H: Jo Reso #: fiss71

CP buyer # Jo Phase #: [aa7
Mortgagecode: [|

aS > Transaction #: JRS 18571
Impound Total: 1 Case tt: ‘a

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