STD 435 Form PDF Details

Engaging with the complexities of the Std 435 form reveals its fundamental role in safeguarding financial integrity within the framework of public administration. This form, official in nature, is a foundational document issued by the State of California, specifically designed to address situations where controller's warrants are reported as never received, lost, destroyed, or stolen. It serves a critical function by providing a structured process for individuals, corporations, partnerships, or government agencies to request a duplicate warrant or stop a payment. The form emphasizes the importance of accountability and security, stipulating that the applicant, whether an individual or acting on behalf of an entity, declares under penalty of perjury that the original warrant has not been cashed or transferred and that they are entitled to its possession. Additionally, it introduces an indemnity agreement, underscoring the applicant's commitment to protect the State of California against any losses incurred from issuing the duplicate warrant, except when the original payee is a governmental agency or entity. Comprehensive instructions on the form guide applicants through the necessary steps, ensuring that all necessary information is provided to facilitate the issuance of a duplicate warrant. This process not only underscores the meticulous attention to detail required in public financial management but also highlights the State's efforts to mitigate potential financial risks, ensuring the integrity and proper allocation of public funds.

QuestionAnswer
Form NameSTD 435 Form
Form Length3 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out57 sec
Other namesstd 435, how to fill out a request for duplicate controller's warrant stop payment example, std 435 warrant request for duplicate, california state controller warrant

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(
)
(Include Area Code)
DAYTIME TELEPHONE NUMBER
That declarant is the owner or custodian of said warrant, has not cashed or transferred same, and is entitled to possession thereof; or the corporation, partnership, or government agency in whose behalf declarant makes this application, is the owner or custodian, has not cashed or transferred same, and is entitled to possession thereof.
(if a corporation is owner or custodian) That declarant is an officer, to wit
Title
of,, a corporation and is authorized to make this application and enter into the indemnity agreement provided herein on behalf of said corporation.
Application is made to the State Controller to issue a duplicate warrant in lieu of said original warrant, and declarant, or partnership or corporation in whose behalf he applies, agrees to indemnify and hold harmless the State, its officers and employees, from any loss resulting from the issuance of said duplicate warrant. (This indemnity agreement is not applicable if the payee of the lost or destroyed warrant is any governmental agency or officer thereof; or if the State of California, agency or officer thereof, is owner or custodian.)
I/We certify (or declare) under penalty of perjury that the foregoing is true and correct.
SIGNATURE OF DECLARANT(S)
DATE SIGNED
1.
DATE SIGNED
2.
TITLE (If signing for Corporation, Partnership or Government agency)
CORPORATION, PARTNERSHIP, OR GOVERNMENT AGENCY NAME (Ifapplicable)
stolen on or about
(give date, including year), under the following circumstances:
never received;
lost/destroyed;
certify or declare:
That the State of California Controller’s warrant described above was
Street
State
City
Zip Code
I, mailing address
IMPORTANT! SEE INSTRUCTIONS (on reverse)
RETURN TO:
REPLACEMENT DATE
State Controller, Administration and Disbursements Division, P.O. Box 942850, Sacramento, California 94250-5871
CODE
REPLACEMENT NUMBER
AND ZIP
EFFECTIVE STOP DATE
ADDRESS
STATUS
NAME

STATE OF CALIFORNIA

REQUEST FOR DUPLICATE CONTROLLER’S WARRANT / STOP PAYMENT

STD 435 (REV. 9-2000) (Page 1)

DATE REQUESTED

AGENCY TELEPHONE NUMBER

WARRANT NUMBER

REQUESTING AGENCY

UNIT/SECTION

DATE ISSUED MMDDYY)

IDENTIFICATION NUMBER

 

AMOUNT (Net Only)

NAME (Exactly as it appears on warrant)

 

FUND6&2NUMBER86(21/<

STATE OF CALIFORNIA

REQUEST FOR DUPLICATE CONTROLLER’S WARRANT / STOP PAYMENT

STD 435 (REV. 9-2000) (Page 2)

WARRANT NUMBER

DATE ISSUED (MM/DD/YYYY)

(This form is to be completed by the Requesting Agency)

AMOUNT (NET ONLY)

NAME (EXACTLY AS IT APPEARS ON WARRANT)

NAME

ADDRESS

AND ZIP

CODE

The State Controller’s Office issued and mailed a duplicate warrant to the payee listed above on

Agency Address: (required)

STATE OF CALIFORNIA

REQUEST FOR DUPLICATE CONTROLLER’S WARRANT / STOP PAYMENT

STD 435 (REV. 9-2000) (Reverse, Page 1)

INSTRUCTIONS

1. The completion of this application form and its return to the office at the address below will enable the State Controller to issue and send to you a duplicate warrant to replace the original which was reported never received, lost/destroyed, or stolen.

2.If you receive the original warrant prior to completing this form:

A.Cash the original warrant;

B.Destroy this form.

3.Please fill out the form carefully and completely. All blanks must be filled. An individual applying in his/her own behalf need not show his/her title, or name of firm, corporation, or governmental agency.

4.If the warrant is drawn to more than one payee, each must sign the application. Each payee must sign his or her own name as it appeared on the original warrant.

5.DO NOT CASH THE ORIGINAL WARRANT ONCE THE APPLICATION HAS BEEN SIGNED AND RETURNED TO THE STATE CONTROLLER’S OFFICE! If the original warrant is presented for payment, it will not clear through the banking system, and processing charges may result. The original warrant is invalid and should be returned to this office if received or recovered.

6.Please note the warrant number and issue date for your records. Inquiries can be made to the original issuing agency (see top of first page).

7.Return all pages to the State Controller’s Office.

8.Mail completed application to:

State Controller’s Office

Administration & Disbursements Division - Post Issuance Unit

P.O. Box 942850

Sacramento, CA 94250-5871

Telephone: (916) 445-3903

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For you to fill out this PDF form, ensure you type in the right information in every single blank:

1. The california state controller warrant necessitates specific details to be inserted. Ensure that the following blank fields are complete:

request for duplicate controller's warrant stop payment conclusion process detailed (part 1)

2. Soon after the prior section is filled out, go on to type in the suitable information in all these: certify or declare That the State, stolen on or about give date, That declarant is the owner or, if a corporation is owner or, Title, of this application and enter into, a corporation and is authorized, IWe certify or declare under, and DATE SIGNED.

Stage # 2 in completing request for duplicate controller's warrant stop payment

3. The third step is normally straightforward - complete all the empty fields in TITLE If signing for Corporation, CORPORATION PARTNERSHIP OR, DAYTIME TELEPHONE NUMBER Include, and DATE SIGNED in order to complete this part.

Ways to fill in request for duplicate controller's warrant stop payment stage 3

4. This next section requires some additional information. Ensure you complete all the necessary fields - This form is to be completed by, NAME EXACTLY AS IT APPEARS ON, WARRANT NUMBER, DATE ISSUED MMDDYYYY, AMOUNT NET ONLY, NAME, ADDRESS, AND ZIP, and CODE - to proceed further in your process!

Filling out part 4 of request for duplicate controller's warrant stop payment

As for WARRANT NUMBER and NAME EXACTLY AS IT APPEARS ON, make certain you do everything correctly in this section. Those two are the most significant fields in this form.

5. As a final point, the following final portion is precisely what you'll have to finish before using the form. The blanks at this point are the following: Agency Address required.

Filling in section 5 in request for duplicate controller's warrant stop payment

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