STAMPED & REDACTED - FOR AGENDA ATTACHMENT - ARNOLD TURER.PDF
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® a 5 ee uy MAR‘ COPA COUNTY one Office of Budget & Finance 301 W. Jefferson St, 9* Floor Phoenix, Arizona 85003 P: 602-506-3561 F: 602-506-4451 Maricopa.gov To: Clerk of the Board From: Office of Budget & Finance, Accounts Payable Date: 8-8-2023 Subject: Affidavit — Replacement of Lost Warrant Please find attached one Affidavit for a lost warrant to be included on the next available Board Agenda. « The attached item has been researched to ensure the warrant in question has not been cashed or previously re-issued. « The original warrant is presumed lost. Please call Walter Chang at 506-8747 if you have any questions. Please return the approved Affidavit to my attention in the Office of Budget and Finance, 9" Floor. Thank you. Re: Fund 675 — D750 / ARNOLD TURER Application for a Duplicate or Stale-Dated Warrant/Check Affidavit/Claim Form This application is for: Duplicate or (I state-Dated (definitions are on page 2) STATE OF ARIZONA Note: Numbers on this form correspond to COUNTY OF MARICOPA numbers on the Instruction sheet which is paae 2 of this form. ARNOLD TURER (1), being first sworn, upon oath deposes and says: Name/Claimant On or about 20-Jun-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 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 himfher in the sum of $ 1,012.00 (3) Signed: nl Vee (4) Note: Please attach a copy of the warrant/check if available and/or any other evidence that a warrant/check was originally issued. a) (5) i yA me this 9 day of Avsust 2024 . NOTARY PUBLIC “4 GERD JACOB BENCH wos . xa Notary Public - Arizona . | Mari Count: My commission expires: Eg cgateaoa coun 03 1b ZO Z1 STE” My Comm. Expires Mar( ean}? Warrant/Check Number 3010153672 (if known) (6) Original Date of Issue (if known) (7) 20-Jun-2023 Reason for original issue of Warrant/Check (8): 1 Payroll 1 For Services or Goods furnished 8/8/2023 1 Treasurer’s refund/payment Other: Settlement, GAX1D 23*25952, D750, Fund 675 COUNTY EXPENSE WARRANT TREASURER OF MARICOPA COUNTY PHOENIX, ARIZONA ANION COUNTY One Thousand Twelve And 00/100 Dollars PAY TO THE ORDER OF ARNOLD TURER For Questions - 602-506-1379 or email AP@MATL.MARICOPA,GOV MARICOPA COUNTY DEPARTMENT OF FINANCE DATE WARRAN 3010 Void After 365 Days T NUMBER 153672 $1,042.00 AMOUNT NOT NEGOTIABLE RETAIN THIS FOR | PAYEE, WARRANT NO. | WARRANT DATE WARRANT AMOUNT YOUR RECORDS SETTLE 3010153672 06/20/2023 $1,012.00 INVOICE NUMBER | DESCRIPTION PURCHASE ORDER NO. | VOUCHER NO. AMOUNT 723TURE WCMAR 10029563 TURER GAX1D D750 230000025952 1,012.00 230000025952 PU