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Home My WebLink AboutWaddell, NatalieN. Mlnlsly of Municipal Affairs Financial Statement , Auditor's Report Ontario and Housing Form 4 Municipal Elections Act, 1996 (Section 78) Instructions: All candidates must complete Boxes A and B. Candidates who receive contributions or incur expenses beyond the nomination fee must complete Boxes C, D, Schedule 1, and Schedule 2 as appropriate. Candidates who receive contributions or incur expenses in excess of $10,000 must also attach an 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 NIM DID YYYY mm DID For the campaign period from (day candidate filed nomination) L2 0 1 4 0 1] 2 0 I to 2 0 1 4 213 1] Primary filing reflecting finances to December 31 (or 45th day after voting day in a by-election) El Supplementary filing including finances after December 31 (or 45' day after voting day in a by-election) Box A. Name of Candidate and Office uanamaie's name as mown on the ballot Last Name Waddell Given Name(s) Natalie v4ame OT orrice Tor is The can oiciate sought election Ward name or no, (if any) Public School BOard I Kitchener Name of Municipality Region of Waterloo ending limit issued by clerk 103,605,95 [] I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and 8 only) Box B: Declaration i, Natalie Waddell Waterloo , a candidate in the municipality of , hereby declare that to the best of my knowledge and belief that these financial statements and attached supporting schedules are true and correct. I ' D I i "_�, Declared before` (clerk or commi ' M commissioner) ' V IC C i C v. in the Q'i - ki o on (yyy middy b I Signature of C erk or Commissioner Date Filed in the Clerk's Office _(yyyy/mm/dd) Signature of Candidate 9603P (2013111) @Queen's Printer for Ontario, 2013 Disponible en frangais Page I of 10 Box [: Statement wf Campaign Income and Expenses LOAN Name of bank u,recognized lending institution Amount borrowed INCOME Total amount o( all contributions (From line 1Ain Schedule 1) Refund of nomination filing fee Sign deposit refund Revenue from fund-raising events not deemed m contribution (From Part III of Schedule 2) Interest earned by campaign bank account Other (provide full details) 1, PayPal transaction to confirm bank account _ Total Campaign income (Do not include loan EXPENSES (Nmo include the value ofcontributions of goods and services) Expenses subject to spending limit Nomination filing fee Inventory from previous campaign used in this campaign (list details in Table 5 of Schedule 1) xuvadiminQ Brochures/flyers 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 on loan until voting day Other (provide full details) 1. 1 Payflall transaction fees for online Contributions � Total Expenses subject to spend:ing limit Expenses not subject uw spending limit Accounting and audit Cost af fund-raising events/activities (list details in Part |Vof Schedule 2) Voting day party/appreciation notices Office expenses incurred after voting day Phone and/or Internet expenses incurred after voting day Salaries, benefits, honoraria, professional fees incurred after voting day Bank charges incurred after voting day Interest charged om loan after voting day Expenses related 0mrecount Expenses related w controverted election Expenses related tn compliance audit Expenses re|u(adtn candidate's disability (provide full details) 1. _ Other (provide full details) _ ~ 2� 3. Total Expenses not subject to spending limit Total Campaign Expenses (C2*C3) 9503P (2013/11) * $ 6,92132 +$ +� +� +$ +0 +� +� + $ 100A +� +$ +� +� +� +* +� + *� +$ 796.50 C3 +� +� +� +� +� + +� +� +� + =$ 62562.62. C4 Page 2 of 10 + +$ +$ +� + + +W +$ +� +� +$ +� +� +� +* +� + *� +$ 796.50 C3 +� +� +� +� +� + +� +� +� + =$ 62562.62. C4 Page 2 of 10 Box D: Calculation of Surplus or Deficit Excess (deficiency) of income over expenses (Income — Total Expenses) (Cl — C4) Eligible deficit carried forward by the candidate from the last election ME= M Total (01 — D2) = $ 461.04 If there is a surplus, deduct any refund of candidate's or spouse's contributions to the campaign $ X461,()4 Surplus (or deficit) for the campaign $ 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 (2013111) Page 3 of 10 Schedule I - Contributions Part I — Summary of Contributions Contribution from candidate (include the value of inventory listed in Table 5) + $ 4,366A7 Contribution from spouse + $ Total value of contributions not exceeding $100 per contributor Include ticket revenue, contributions in money, goods and services where the total contribution, from a contributor is $100 or less (do not include contributions from candidate or spouse). + $ 256.85 Total value of contributions exceeding $1!00 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 a contributor exceeds $100 (do not include contributions from candidate or spouse). Less: Contributions returned or payable to the contributor Contributions paid or payable to the clerk, including contributions from anonymous sources exceeding $10 Total Amount of Contributions (Record in Box C) + $ 2,300.00 Part 11 —Ust of Contributions from Each Single Contributor Totalling more than $100 Table 1: Monetary contributions from individuals other than candidate or snouse b,923-32 1A Name Full Address Amount $ Thomas Waddell 16 Edward Street, London ON, N 31-11 250.00 Vina Waddell 9,60 Teron Road, #911, Kanata ON 1 21{ 2136 400.0 0, George Dietrich ... . ...... Peter Maloney P117 - 3267 King Street East, Kitchener ON N2A 4A4 1.908 - 55 Green Valley Drive, Kitchener ON N21? IZ6 150.00 250.10 9503P (2013111) Page 4 of 10 Name Full Address Amount $ f-I Additional information is listed on separate supplementary attachment Total Table 2. Monetary contributions from corporations or unions Name (Legal and Carrying on Business As) Full Address President or Business Manager Authorized Representative Amount $ Lawycrl,ocatexa Inc. 498 Eagle Street Norlb, Suite 206 Cambridge ON Natalie Waddell, Mark Robin-S 750,00 750.00 Additional information is listed on separate supplementary attachment Total Table 3: Contributions in goods or services from Individuals other than candidate or spouse (Note. must also be recorded as expenses in Box Cl Name Full Address Description of Goods Value $ or Services Collin Grasley 18 Kirkland Street, Lower Level, Graphic, esi n Guelph ON N1 H 4X8 500.00 9503P (2013/11) Page 5 of 10 Name Full Address Description of Goods or Services Value $ 500.00 F1 Additional information is listed on separate supplementary attachment Total 9503P (2013111) Page 6 of 10 Table 4: Contributions in goods or services from corporations or unions (Note: must also be recorded as expenses in Box C) Name of Corporation Full Address President or Authorized Description of Value $ (Legal and Carrying on Business Manager Representative Goods or Services Business As) ❑ Additional information is listed on separate supplementary attachment Total Total Part 11 Contributions (Add Totals from Tables 1 -4) (Record in Part I - Summary) $ 1 B Part III - Inventory Table 5: Inventory of Campaign Goods and Materials from Previous Campaign used in this Campaign 9503P (2013/11) Page 7 of 10 Description Date Acquired (yyyylmmldd) Supplier Current Market Value $ Quantity Total Value $ F] Additional information is listed on separate supplementary attachment Total 9503P (2013111) Page 8 of 10 Schedule 2 - Fundraising Events and Activities Fundraising EventlActivity Complete a separate schedule for each event or activity held Additional schedule(s) attached Description of fundraising eventlactivity Date of event/activity (yyyylmmldd) 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 2B Total Ticket Revenue (2A X 2B) (include in Schedule 1) Part II - 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. + $ 8. + $ Total Part IV Expenses (include in Box C) _ q; 9503P (2013111) Page 9 of 10 Auditor's Report Municipal Elections Act, 1996 (Section 78) A candidate who has received contributions or incurred expenses in excess of $10,000 must attach an auditor's report. Professional Designation of Auditor Municipality Contact Information Date (yyyylmm /dd) Last Name First Name Licence Number Address Suite /Unit No. Street No. Street Name City/Town Province Postal Code Telephone No. (including area code) Fax No. Email Address ext. The report must be done in accordance with generally accepted auditing standards and must: • 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 ❑ Report is attached Personal information, if any, collected on this form is obtained under the authority of sections 78 and 95 of the Municipal Elections Act, 1996. Under section 88 of the Municipal Elections Act, 1996 (and despite anything in the Municipal Freedom of 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 (2013/11) Page 10 of 10