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Financial ' - —__-_—' '_ -_______ __ " _
Form 4
Municipal Elections Act, /9S8 (Section 78)
Instructions:
All candidates must complete Boxes A and B. Candidates who receive contributions or incur expenses beyond the nomination fee
moe1compde$oBmxeoO,D'Schedu|o1,and8ohedu|*2aumppmpricdo.Candidatoowhonacoivouon!ributimnmmrinourexpenses|m
excess of$1O.0O0 must also attach mm Auditor's Report.
All surplus funds (after any refund to the candidate or his or her spouse) shall, be paid immediately over to the clerk who was responsible
for the conduct of the election.
YYYY mm DD YYYY MM C0
For the campaign period from (day candidate filed nomination) to
Primary filing reflecting finances tm December 31 (or 451h day after voting day inaby-e|umtion
Supplementary filing including finances after December 31 (or 45m day after voting day inmby-a|eodon)
Box A: Name of Candidate and Office
Candidate's name as shown on the ballot
Last Name Given Name(s)
Drewitz Harald
Name of office for which, the candidate sought election, Ward name or no. (if any)
Councillor 7
Name ofMunicipality
City ofKitchener
Spending limit issued by clerk
$20,525.25
F] | did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box and B only/
Box B: Declaration
|, Huonid Drevvi(z , ocand|date in the municipality of
City f Kitchener .hereby declare that 10 the best ufnoy knowledge and belief that these
financial statements and attached supporting schedules are true and rprrnnt
Declared before (clerk or commissioner)
LI//"4r �__�j4 �-/9_1
Signature of Clerk or Commissioner Signature of Candidate
0, 1 s ( 05 1 -Z 41:
4
Date Filed in the Clerk's Office (yyyy/mm/dd)
9503p(2013111} m Queen's Printer for Ontario, 2013 uisp^nmwwn+nngaw Page Imn
Box C: Statement of, Campaign Income and Expenses
LOAN
Name of bank m recognized lending institution i// Canada Trust
Amount borrowed - - ' ' ' - - - +
INCOME
Total amount mf all contributions (From line 1Ain Schedule 1) + 3
Refund of nomination filing fee + $ lDO0
Signdopoebmfumd! +
Revenue from hund'ndahng, events not deemed a contribution (From Part UUuf
Schedule 2) + $
Interest earned by campaign bank account +
Other (provide full details)
2. +
3. +
Total Campaign Income (Do not include loan) =
EXPENSES (Mote: include the value of contributions of goods and services)
Expenses subject to spending limit
Nomination filing fee +
Inventory from previous campaign used in this campaign (list details im Table 5
of Schedule 1) +
Advertising +
8mohureeM|yem +
Signs (including sign deposit) +
Meetings hosted +
Office expenses incurred until voting day +
Phone and/or Internet expenses incurred until voting day +
Salaries, benefits, honoraria, professional fees incurred until voting day +
Bank charges incurred until voting day +
Interest charged om loan until voting day +
Other (provide full details)
$ 132373.58 C1
100.00
�
1. Re{rack(ablcBnooer
l
\ 35
3
+
$ 686M
3.
+
$
34,33
1. Re{rack(ablcBnooer
+
\ 35
2
+
$ 686M
3.
+
Total Expenses subject ho spending limit
=
C2
Expenses not subject to spending limit
Accounting and audit
+
Cost of fund-raising events/activities (list details in Part IV Of Schedule 2)
+
Voting day party/appreciation notices
+
Office expenses incurred after voting day
+
Phone end/or Internet expenses incurred after voting day
+
Sa|ehom, bomoNta, honmnmhe, professional fees incurred after voting day
+
Bank charges incu«,adafter voting day
+
Interest charged on loan after voting day
+
Expenses related 1orecount
+
Expenses related to controverted election
+
Expenses related tocompliance audit
+
Expenses related tocandidate's disability (provide full details)
1.
+
z.
+
Other (provide full details)
1. -1111
+
$
2.
+
3.
+
Total Expenses not subject to spending limit
=
C&
Total Campaign Expenses (C2+C3)
= 13 C4
9503P (2013111)
Page zme
Box D: Calculation of Surplus or Deficit
Excess (deficiency) of income over expenses (Income — Total Expenses)
(01 — C4) + $ 0.00 Di
Eligible deficit carried forward by the candidate from the last election $ D2
Total (D1 — 132) $ 01.00
If there is a surplus, deduct any refund of candidate's or
spouse's contributions to the campaign $
Surplus (or deficit) for the campaign $ 0.00 D3
If line D3 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerk who was
responsible for the conduct of the election.
Amount of $
paid to municipal clerk in the municipality of
9503P (2013/11) Page 3 of 8
Schedule Y~Contributions
Part |— Summary of Contributions
Contribution from candidate (include the value of inventory listed in Table 5) + $ 9901000
ContriibuUon from spouse +
Total value of contributions not exceeding *1O0 per contributor
*
Include ticket revenue, contributions inmoney, goods and services
where the total contribution from e contributor |a$1OOor less (do not
include contributions from candidate orupuume). + 1,398.00
Total value of contributions exceeding $100 per contributor (from line 1 B; list
details in Tables 1-4)
�
Include ticket revenue, contributions in money, goods and services where
the total contribution from o contributor exceeds $180 (do not include
contributions from candidate oropoumo). + 240000
Leas: Contributions returned mr payable 10 the contributor — $ 424.42
Contributions paid or payable $z the clerk, including contributions from
anonymous sources exceeding $1U —
Total Amount od Contributions (Record |n Box C) = 13273.58 1A
Part U_List of Contributions from Each Single Contributor Totalling more than $100
Table 1: Monetary contributions from individuals other than candidate or spouse
Name
Full Address
Amount $
Michael Knell
413 Keatsway Dr. Unit 2
Waterloo, ON N2L 5S7
150,00
Hugo Hembruch
748 Hidden Valley Rd.
Kitchener, ON N2C 2S6
300,00
Jagdeepakpal S.'Fhind
519 Larkspur Lane
Burlington, ON L7T 4L7
200.00
Eli Boich
10 Bradley Place
Kitchener,, ON N2A 2B3
200.00
Mac Voisin
Kitchener, ON N2N IW4
2046 Old Mil I Rd,
Kitchener, ON N2P I E2
250-00
Otto Jeske
292 Sims Estate Dr.
200.00
Kevin Flatt.
90Bankside Dr.
Kitchener, ON N2N 3G]
150.00
F-1 Additional information is listed on separate supplementary attachment Total
1,650.00
9503P (2013/11) Page 4 of 8
Table 2: Monetary contributions from corporations or unions
Name (Legal and Carrying on Full Address President or Authorized Amount $
Business As Business Manager Representative
Jay Fencing LTD 29 Northfield Drive West Jay Aissa Jay Aissa, 750.0O
Wawrloo, ON N2L 4E6
................... . . .
Additional information is listed on separate supplementary attachment Total 750.00
Table 3: Contributions in goods or services from individuals other than candidate or spouse
(Note: must also be recorded as ex peases in Box C)
Name Full Address Description of Goods Value $
I or Services
[:] Additional information is listed on separate supplementary attachment
Total
9503P (2013111) Page 5 of 8
Table 4: Contributions n goods or services from corporations or unions (Note., must also be recorded as expen es in Box C)
Name of Corporation Full Address President or Authorized Description of Value $
(Legal and Carrying Business Manager Representative Goods or Services
Business As)
F� Additional information is listed on separate supplementary attachment Total I
Total Part 11 Contributions (Add Totals from Tables 1-4) (Record In Part I — Summary) $ 24001.001 B
Part III — Inventory
Table 5: Inventory of Campaign Goods and Materials from Previous Campaign used in this Campaign
(Note: value must be recorded as a contribution from the candidate and as an expense)
Description Date Acquired Supplier Current Market Quantity Total Value $
� (vvvv/mm/dd) � Value $
[:] Additional information is listed on separate supplementary attachment Total
9503P (2013111) Page 6 of 8
9503P (2013111 )
Page 7 of S
Schedule 2 — Fundraising Events and Activities
Fundraising EvenVActivity
Complete a separate schedule for each event or activity held
❑ Additional schedule(s) attached
Description of fundraising eventlactivity
Date of event/activity (yyyy /mmldd)
Part I — Ticket Revenue
Admission charge (per person)
(If there are a range of ticket prices, attach complete breakdown of all ticket
sales)
+
$ 2A
Number of tickets sold
X
213
Total Ticket Revenue (2A x 2B) (Include in Schedule 1)
= $
Part It — Other revenue deemed a contribution
(provide details (e.g. revenue from goods sold in excess of fair market value))
1.
+
$
2.
+
$
3.
+
$
4.
+
$
5.
+
$
Total Part II Revenue (include in Schedule 1)
_ $
Part III — Other revenue not deemed a contribution
(provide details (e.g. contributions of $10 or less; market value of goods or services sold))
1.
+
$
2.
+
$
3.
+
$
4.
+
$
5.
+
$
Total Part III Revenue (include in Box C)
_ $
Part IV — Expenses related to fundraising event or activity (provide details)
1.
+
$
2.
+
$
3.
+
$
4.
+
$
5.
+
$
6.
+
$
7.
+
$
g,
+
$
Total Part IV Expenses (include in Box C)
_ $
9503P (2013111 )
Page 7 of S
Auditor's Report
Municipal Elections Act, 1996 �Section 78)
Aoandidate who has received contributions or incurred expenses in excess cd$10,000 must attach mn auditor's report.
Professional Designation of Auditor
Municipality
Date (yyyy/mm/c1d)
Waterloo
2015/01/16
Contact Information
Name
icence Number
Last Name
First Name
Lund
Brad
1-17482
Address
Suite/Unit No,
Street No.
Street Name
1183
King Street East
Cityrrown
Province
Postal Code
Postal Code
Kitchener
ON
,G 2N3
Telephone No, (induding area code)
Fax No.
Email Address
519-576-0101 ext.
519-576-8888
bltiiid@luii(latidassociates.coiii
The report must be done in accordance with generally accepted auditing standards and must:
w set out the scope of the examination
° provide an opinion as to the completeness and accuracy of the financial statement and whether it is free of material
misstatement
0 Report is attached
Personal information, d any, collected on this form is obtained under the authority of sections 78 and 95 of the Municipal Elections Act,
/00G Under section 8Qmf the Municipal Elections Act, 1996 (and despite anything in the Municipal Freedom cf Information and
Protection of Privacy Act) documents and materials filed with or prepared by the clerk or any other election official under the Municipal
Elections Act, 1996 are public records and, until their destruction, may be inspected by any person at the clerk's office at a time when
the office is open. Campaign financial statements shall also be made available by the clerk in an electronic format free of charge upon
request.
9503P (2013111) Page 8 of 8