REDACTED - FOR AGENDA ATTACHMENT - GREAT AMERICAN TITLE AGENCY INC.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
Maria Quitangon
maria.quitangon@maricopa.gov
602-506-1958
Cathy Sanchez ( y, ?
cathy.sanchez@maricopa.gov
602-506-7881
Re: Stale Dated Warrant
Name Warrant Amount | Dept/School
No
Great American Title Agency 945347 $158.33 | Treasurer
By: Alycia R. Crook

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

This application is for: oO Duplicate or lal 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.
Alycia R Crook (1), being first sworn, upon oath deposes and says:
Name/Claimant
On or about 6/29/2022 (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
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 $. 158.33 .(3)

Signed: Aiwa e (ids (4)

Print name: (required) Alycia R Crook

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 2D aay of Auopw 2622,

NOTARY PUBLIC Gilt JOAN CROSS
Avreaussa\ Notary Public - State of Arizona
M os ; Eligesp uAricora county
yy commission expires: Oy =) ommission
(ae) 31] UL ell — (seal)

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Warrant/Check Number
(if known) (6) 945347

Original Date of Issue
(if. known) (7) 6/29/2022

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

0 For Services or Goods furnished
Treasurer's refund/payment Overpayment of 2021 Taxes

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
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Great American

TITLE AGENCY, INC.

Bruce E. Beverly
Chief Executive Officer

August 30, 3023
Maricopa County Treasurer

301 West Jefferson Street # 100
Phoenix, AZ 85003

Re: — Check # 945347
Amount: $158.33
Check Date: 6/29/2022
To Whom it May Concern:
Please be advised that Alycia Crook is authorized by Great American Title Agency, Inc. to
file a claim on our behalf so secure the refund of the specified above which represents an

overpayment of taxes.

Should you have any questions about this authorization, please do not hesitate to contact me.

Sincerely,

Bruce E. Beverly
Chief Executive Officer

Maricopa County Treasurer's Office 503-77-332 1 9/7/2023 8:53:41 AM
fiBE 503-77-332 1 - x
File Help

Year | Description | Act Date | Tran Num | Amount | Images | Pmt Date | Half Code | Act Time | a

2023) INFOSTATEMENT 2023-08-26 N 12:00:00 4M

2023) TAX BILL 2023-08-26 N 12:00:00 AM

2022 TAX PAYMENT 2023-04-25 MO -F574 $613.82 N 2023-04-24 F 8:55:00 PM

2022 TAX PAYMENT 2022-10-25 MO -F574 $613.82 N 2022-10-25 1 8:46:00 PM

2022 INFOSTATEMENT 2022-08-20 v 12:00:00 AM

2022) TAX BILL 2022-08-20 v 4

055-33973

N

$158.33

2021 CTXIMPOUND 2022-05-04 Y
2021 TAX PAYMENT 2022-04-28 MO -F131 $158.33 N 2022-04-28  F 7:33:00 PM ¥
< >
Parcel #: |503-77-332 Activity: JREFUND Act Date:J06/29/22
Tax ‘Year: [2021 Tran #[- ea Act Time {12-00 AM
Activity Detail | Address Detail |
CP #: {o Check Date: [06/29/22
Buyer #: jo Check #: [945347
Fund: (26 Refund Amount: | $158.33
Click icon for Disbursements Inquiry. ----->
View Image... | Close

Maricopa County Treasurer's Office Refund ID 2022013975 MANUAL 9/7/2023 8:54:40 AM

& Refund ID 2022013975 MANUAL _ Oo x
File Help
EIry
RefundAmount, [$158.33 Requester, [MARC.LYLES on 6/28/2022
Refund Reason: [Overpayment of property taxes Status: [DISBURSED on 6/28/2022 |

Slip 1p; [202200471

Address: [GREAT AMERICAN TITLE AGENCY Check Request, |MAIL

Reference #: |

Impounds | Stub | Comments |

Impound #1
Source Fund | Linked | Amount | Tax'Year_| Status Parcel/Roll:/503-77-332 Dest fund : |026 |
064 Tue $158.33 2021 READ] §cpy. [0 —~esot: [0S

CP buyer #10 ~ Phase #: [0 |

Mortgage code : |
$ > Transaction #: [05533973
Impound Total : 1 Case tt: