Arizona > Local County > Maricopa > Superior Court > Financial
Stop Payment Affidavit 501 - Arizona
| Stop Payment Affidavit Form. This is a Arizona form and can be used in Financial Superior Court Maricopa Local County . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
C L E R K O F T H E C O U R T S U P E R I O R C O U R T O F A R I Z O N A M A R I C O P A C O U N T Y 201 WEST JEFFERSON PHOENIX, ARIZONA 85003 MICHAEL K. JEANES (602) 506-3676CLERK FAX# (602) 506-7684 TDD# (602) 506-3211Dear Affiant/Payee Enclosed is the Stop Payment Affidavit that you requested. To avoid any delays in processing, please follow the instructions listed below and return it to our office: When completing the Stop Payment Affidavit, print legibly or type the information requested. Be sure to sign the affidavit on the designated signature line provided near the bottom. Verify that the information on the affidavit is correct. Of it is not, strike out the wrong information, make the necessary correction(s), and initial the change. The Stop Payment Affidavit must be notarized when it is returned by mail, or the affiant/payee may present it in person to a Deputy Clerk of the Court. Pursuant to A.R.S. 12-284 & 12-115, there is a non-refundable charge of $10.00 per item/stop payment, which must be paid at the time we accept the Stop Payment Affidavit. Please refer to the enclosed billing form and return it with the affidavit. If the missing check(s) in question has been cashed, you will be notified. If you have any further questions regarding the Stop Payment Affidavit, Please contact our office. RESTITUTION FINES AND REIMBURSEMENTS (602) 506-8621 Form 501 Clerk of Superior Court of Arizona in Maricopa County September 10, 1999 ALL RIGHTS RESERVED <<<<<<<<<********>>>>>>>>>>>>> 2 STOP PAYMENT AFFIDAVIT STATE OF ARIZONA Return to: The Clerk of the Superior CourtCOUNTY OF MARICOPA Restitution Fines and Reimbursement Section 201 W Jefferson Street Phoenix Arizona 85003 I, , being duly sworn on oath, depose and say: That I am the recipient of court ordered payments on case through the Superior Court in Maricopa County and that I have not received or cashed the following check(s) issued by the Clerk of the Superior Court. I hereby request a stop payment on the following check (s): Check # Dated Amount $ . Check # Dated Amount $ . Check # Dated Amount $ . I understand a stop payment will not be placed until ten (10) working days after the original issue date. If I have had an address change, I must wait the ten (10) working days to allow time for my check to forward to my new address. Per A.R. S. 12-284 & 12-115, I understand a non-refundable charge of $10.00 per check which covers research and cost, must be paid at the time of the stop payment request. (Please make check or money order payable to: The Clerk of the Superior Court). This process can be expedited through the use of a credit card and by calling (602) 506-8621. If the requested check has already cleared the bank, I will be notified by the Clerk of the Court of the paid date. I have been advised that if I cash the above referenced check, I will be responsible for reimbursement of same. ____________________________ ____________________________ Signature of affiant address _____________________________ ____________________________telephone number city and state Subscribed and sworn before me this _____day of ____________,______ My commission expires: ___/___/__ ____________________________ ____________________________Notary public or Deputy Clerk Form 501 Clerk of Superior Court of Arizona in Maricopa County September 10, 1999 ALL RIGHTS RESERVED
|
|||||||
