REDACTED - FOR AGENDA ATTACHMENT - QUICKTRIP CORPORATION.PDF
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John M. Allen, Treasurer 301 West Jefferson St., Rm. 100 Phoenix, Arizona 85003 v MARICOPA COUNTY ie TREASURER’S OFFICE http://treasurer.maricopa.gov To: Clerk of the Board clerk.agenda@maricopa.gov Dorene.Stretar@Maricopa.Gov From: Treasurer's Office vo Maria Quitangon maria.quitangon@maricopa.gov 602-506-1958 Cathy Sanchez (?6 cathy.sanchez@maricopa.gov 602-506-7881 Re: Stale Dated Warrant Name Warrant Amount Dept/School No Quiktrip Corporation 939881 $19,962.59 | Treasurer ee + dia ae a | Cor “<> os Application for a Duplicate or Stale-Dated Warrant/ Check Affidavit/Claim Form This application is for: O Duplicate or 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. QUIKTRIP CORPORATION (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 93/02/2022 (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 resented for payment within one year after the date of issuance. a the best é ue Knowledge, re ceacfiaarrwet Ler Nor Fecened and became lot In te mail. 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 aed in the sum of $ $19,962.59 (3) Signed: (4) Print name: (required) G. Harold Christian, VP Operations (Atty-in-Fact) 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 ZY“ day of OC*OlWeC 2923. ill, RN Ny DAOoHNA West Sy EWE,’ fit, Se EL, fee, ‘Cc My commission expires: i 7990776 3: 04/30/2021 \My COMM, aed T T ‘. ° 4, 04/30/2! | Warrant/Check Number 939984 (if known) (6) May USS Original Date of I vgn (if inown) o oszav22 Reason for original issue of Warrant/Check (8): Payroll aYFOu OO 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 ane ct m at al we Maricopa County PM Treasurer's Office Refund ID 2022003288 MTG_BATCH File Help & Refund ID 2022003288 MTG_BATCH elley Refund Amount: [srs 562.59 Requester: Refund Reason: [Mo tgage Rejects - see attached list Status: : [MORTGAGE on 2/14/2022 : |DISBURSED on 2/14/2022 Slip ip: [202200146 Address: Qui Cre KTRIP CORPORATION RYAN Check Request. [MORTGAGE DESK Reference #: [MTGBATCH 01014 Impounds | Stub | Co ments | Impound Total: 1 Case #: | Impound #1 | | Source Fund | Linked | Amount | TaxYear_| Stat. Parcel/Roll:[000-00-000 Destfund:[026 | 064 False $19,962.59 2021 REA CP Ht: fo Reso tt: fo cPowertt:[0 ——Phasett: [0 | Mortgage code: [A172 | £ > Transaction # : |Moat72 tC” -——_— 10/27/2023 1:02:15