HomeMy WebLinkAboutMarsh, Sarah}r Ontario Ministry of Municipal Affairs Financial Statement - Auditor's Report
and Housing
Form 4
Municipal Elections Act, 9996 (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 MM DD YYYY MM DD
For the campaign period from (day candidate filed nomination) L 2 0 1 410. 41 1 6 to 2 0 1 41 1 2 3 1
F71 Primary filing reflecting finances to December 31 (or 45°1 day after voting day in a by- election)
❑ Supplementary filing including finances after December 31 (or 45'h day after voting day in a by- election)
Box A: Name of Candidate and Office
Candidate's name as shown on the ballot
Last Name Given Name(s)
Marsh Sarah
Name of office for which the candidate sought election Ward name or no. (if any)
Kitchener City Council 10
Name of Municipality
City of Kitchener
Spending limit issued by clerk
$ 20,735.20
❑ I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and B only)
Box B: Declaration
I. Sarah Marsh a candidate in the municipality of
City of Kitchener hereby declare that to the best of my knowledge and belief that these
financial statements and attached supporting schedules are true and correct.
Declared before (clerk or commissioner)
in the LI JIY or lei frell'Elklep
on (yyyy/mm/dd) ��U 5-/P42 7
natu of Clerk or ri missioner
,�; LOis'_n ,5 L�7
Date Filed in t1fe ClerlCs Office (yyyylmmldd)
Signature of Candi to
9503P (2013/11) ® Queen's Printer for Ontario, 2013 Oisponible en frangais Page 1 of 12
Box C: Statement of Campaign Income and Expenses
LOAN
Name of bank or recognized lending institution
Amount borrowed $
INCOME
Total amount of all contributions (From line 1A in Schedule 1)
+
$
8,574.75
Refund of nomination filing fee
+
$
100.00
Sign deposit refund
+
$
Revenue from fund- raising events not deemed a contribution (From Part III of
Schedule 2)
+
$
1 20,00
Interest earned by campaign bank account
+
$
0.20
Other (provide full details)
1.
+
$
2.
+
$
3.
+
$
Total Campaign Income (Do not include loan)
_
$
8,794.95 C1
EXPENSES (Note: include the value of contributions of goods and services)
Expenses subject to spending limit
Nomination filing fee
+
$
100.00
Inventory from previous campaign used in this campaign (list details in Table 5
of Schedule 1)
+
$
Advertising
+
$
1,006.06
Brochures /flyers
+
$
2,384.71
Signs (including sign deposit)
+
$
4,205.18
Meetings hosted
+
$
109.57
Office expenses incurred until voting day
+
$
214.40
Phone and /or Internet expenses incurred until voting day
+
$ .
Salaries, benefits, honoraria, professional fees incurred until voting day
+
$
Bank charges incurred until voting day
+
$
7,75
Interest charged on loan until voting day
+
$
Other (provide full details)
1. Promotional materials (buttons, t- shirts)
+
$
426.00
2. Paypal charges
+
$
66.86
3. Credit card fees
+
$
19.76
Total Expenses subject to spending limit
=
$
8,541.19 C2
Expenses not subject to spending limit
Accounting and audit
+
$
Cost of fund - raising events /activities (list details in Part IV of Schedule 2)
+
$
1,018.86
Voting day party /appreciation notices
+
$
197.75
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 on loan after voting day
+
$
Expenses related to recount
+
$
Expenses related to controverted election
+
$
Expenses related to compliance audit
+
$
Expenses related to candidate's disability (provide full details)
1.
+
$
2.
+
$
3.
+
$
Other (provide full details)
I. Credit card fees
+
$
13.58
2.
+
$
3.
+
$
Total Expenses not subject to spending limit
=
$
1,230.19 C3
Total Campaign Expenses (C2 + C3)
_ $ 9,77138 C4
9503P (2013111)
Page 2 of 12
Box D: Calculation of Surplus or Deficit
Excess (deficiency) of income over expenses (income — Total Expenses)
(Cl — C4) + $ - 976.43 D1
E=ligible deficit carried forward by the candidate from the last election — $ D2
Total (D1 — D2) _ $ - 976.43
If there is a surplus, deduct any refund of candidate's or
spouse's contributions to the campaign _ $
Surplus (or deficit) for the campaign = $ - 976.43 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 12
Schedule 1 - Contributions
Part I — Summary of Contributions
Contribution from candidate (include the value of inventory listed in Table 5) + $
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).
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 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)
+ $ 3,087,00
+ $ 5,487.75
_ $ 8,574.75 1A
Part If — 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 $
George McDonald
73 Rossford Crescent
Kitchener, ON
750.00
N2M 2H8
Bob Marsh
154 Avondale Ave S
Kitchener, ON
750.00
N2L 2C6
Alison Waltch
472 Parkwood Crt Waterloo ON N2L4A8
500.00
Kim Knowles
204 Waterloo St, Kitchener, ON N2H 3 W 1
200.00
Jordan Marsh
154 Avondale Ave S
Kitchener, ON
220.00
N2L 2C6
Margaret Nally
189 Mary St Waterloo ON N2J I S 1
300.00
Bryan Smith
86 Louisa St
Kitchener, ON
200.00
N2H 5M I
Jason Vander Meulen
121 Belmont Ave, Waterloo ON N2L 2A8
200.00
Senta Ross (prefers to be listed
40 Carl St
anonymously)
Kitchener, ON N2M 2V6
200.00
Theron Kramer
22 Simeon St. Kitchener, ON N2H 1 S 1
150.00
9503P (2013 /11) Page 4 of 12
Name
Full Address
Amount $
Felix Munger
91 Shanley Street, Kitchener, ON N21 -1 51' l
160.00
Mason Tikl
74 Waterloo St Kitchener ON N2H 3V4
110.00
Brian Hamill
444 Old Oak Drive Waterloo ON N2T 2V8
200.00
Terra Fielder
157 Lucan Ave Waterloo, ON N2J IA5
150.00
Kitchener, ON N213 3X2
500.00
Waterloo Region Labour
120 Ottawa St. North,
Marc Xuereb
Marc Xeureb
Council
Suite 203, Kitchener,
200.00
ON, N21-1 3K5
[] Additional information is listed on separate supplementary attachment Total
4,090,00
Table 2: Monetary contributions from corporations or unions
Name (Legal and Carrying on
Full Address
President or
Authorized
Amount $
Business As)
Business Manager
Representative
Mitek Fine Auto Inc
207 Centennial Court,
Mike Tikl
Mike Tikl
Kitchener, ON N213 3X2
500.00
Waterloo Region Labour
120 Ottawa St. North,
Marc Xuereb
Marc Xeureb
Council
Suite 203, Kitchener,
200.00
ON, N21-1 3K5
Together in Education
610 Wabanaki Dr
Nancy Hutcheson
Nancy Hutcheson
Kitchener, ON
100.00
N2C 2K4
IBEW Local 804
3 Forwell Rd
George Couch
George Couch
Kitchener, ON
150.00
N2B l W3
Afterglow
75C Northland Rd,
Waterloo, ON N2V I Y8
George McDonald
George McDonald
197.75
9503P (2013111) Page 5 of 12
Name (Legal and Carrying on Full Address President or Authorized Amount $
Business As) Business Manager Representative
[] Additional information is listed on separate supplementary attachment
Total
Table 3: Contributions in goods or s rvices from individuals other than candidate or spouse
(Note: must also be recorded as expenses in Box C)
Name Full Address Description of Goods Value $
or Services
.1,1 47.75
John Smola Used H- !Tames for
Signs 200.00
9503P (2013/11) Page 6 of 12
Name Full Address Description of Goods Value $
or Services
❑ Additional information is listed on separate supplementary attachment Total I 200.00
9503P (2013111) Page 7 of 12
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 I Authorized Description of Value $
(Legal and Carrying on Business Manager Representative Goods or Services
Business As)
Afterglow 75C Northland Rd, George George rise of Office
Waterloo, ON N2V McDonald McDonald supplies 50.00
IY8
9503P (2013111) Page 8 of 12
Name of Corporation
(Legal and Carrying on
Business As)
Full Address
President or
Business Manager
Authorized
Representative
Description of
Goods or Services
Value $
❑ Additional information is listed on separate supplementary attachment Total I 50.00
Total Part II Contributions (Add Totals from Tables 1-4) (Record in Part I - Summary) $ 5,487.75 1 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 $
(yyyylmmldd) Value $
9 503 P (2013111) Page 9 of 12
Description Date Acquired Supplier Current Market Quantity Total Value $
(yyyylmm /dd) Value $
❑ Additional information is listed on separate supplementary attachment Total
9503P (2013h I) Page 10 of 12
Schedule 2 — Fundraising Events and Activities
Fundraising Event/Activity
Complete a separate schedule for each event or activity held
Q Additional schedule(s) attached
[Description of fundraising eventlactivity Kypreos Restaurant Fundraiser
Date of event/activity (yyyylmm /dd) 2014/06/19
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. Monetary contributions
+
$
2,175.00
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. Handinade felts by Sarah Granslcou
+
$
40.00
2. Paintings by James Nye
+
$
80.00
3.
+
$
4.
+
$
5.
+
$
Total Part III Revenue (include in Box C)
Part IV — Expenses related to fundraising event or activity (provide details)
1. Kvpreos Restaurant - Food for June 1912014 fundraiser
+
$
663.60
2. Payment for artwork for June 19/2014 fiindraiser
+
$
65.00
3.
+
$
4.
+
$
5.
+
$
6.
+
$
7.
+
$
8.
+
$
Total Part IV Expenses (include in Box C)
_ $ 21175.00
_ $ 120.00
_ $ 728.60
9503P (2013/11) Page 11 of 12
Auditor's Report
Municipal Elections Act 9996 (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 Date (yyyylmmldd)
Contact Information
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 (2013111) Page 12 of 12
Schedule 2 -- Fundraising Events and Activities Supplementary Schedule
Description of Fundraising event: private party held in support of the
Campaign to Elect Sarah Marsh
Date of events:
October 2nd, 2014
Part I — Ticket Revenue
Not applicable
Total Ticket Revenue $0.00
Part II — Other revenue deemed a contribution
Monetary contributions $815.00
Total Part II Revenue (include in Schedule 1) $815.00
Part III — Other revenue not deemed a contribution
Not applicable
Total Part III Revenue (include in Box C) _ $0.00
Part IV — Expenses related to fundraising event or activity
1. Martin's Family Fruit Farm food for Oct 2nd event $60.00
2. LCBO expenses for Oct 2nd event $37.55
3. Cheeses Murphy catering for Oct 2nd event $192.71
Total Part IV Expenses (include in Box C) $290.26