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Home My WebLink AboutBaskin, JamesNIL 7— - Financial Statement - Auditor's Report _Ontario Ministry of Municipal Affairs Candidate -Form 4 Municipal Elections Act, 1996 (Section 88.25) Instructions All candidates must complete Boxes A and B. Candidates who receive contributions or incur expenses 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 their spouse) shall be paid immediately over to the clerk who is responsible for the conduct of the election. YYYY MM DD YYYY mm DD For the campaign period from (day candidate filed nomination) 1 2 0 1 8 1 0 7 1 1 3 1 to 1 2 0 1 81 1 21 1 01 Initial filing reflecting finances to December 31 (or 45 days after voting day in a by-election) Supplementary filing including finances after December 31 (or 45 days after voting day in a by-election) Box A: Name of Candidate and Office Candidate's name as shown on the ballot Last Name or Single Name Given Name(s) BASKIN Jarnes Raymond Office for which the candidate sought election Ward name or no. (if any) Councillor 18 Municipality Kitchener Spending Limit - General Spending Limit - Parties and Other Expressions of Appreciation $ 17,376M � $ F� I did not accept any contributions or incur any expenses. (Complete Boxes A and B only) Box B: Declaration I, James Raymond AS IN declare that to the best of my knowledge and belief that these financial statements and attached supporting schedules are true and correct. Signature of 01F. /�.. Id Date (yyyy/mm/dd) Date Filed (yyyy/mm/dd) Time Filed Initial of Candidate or Agent (if filed in person) Signature of Clerk or Designate fat �"�12 f l� 1 /�3�� n - 44 9503P (2018/04) @ Queen's Printer for Ontario, 2018 Disponible en frangais Page 1 of 8 Box C: Statement of Campaign Income and Expenses LOAN Name of bank orrecognized lending institution Amount borrowed $ INCOME Total amount of all contributions (from line 1AinSchedule 1) Revenue from items $25orless Sign deposit refund Revenue from fundraising events not deemed ocontribution (from Part III uf Schedule 2) Interest earned bycampaign bank account Other (provide full details) 2. 3. 4. 5. Total Campaign Income (Do not include loan) EXPENSES (Note:include the value of contributions of goods and services) Expenses subject hugeneral spending limit Inventory from previous campaign used in this campaign (list details in Table 4 of Schedule 1) Advertising Brochures/flyers Signs (including sign deposit) Meetings hosted Office expenses incurred until voting day Phone and/or int*rnetexpenses incurred until voting day Salaries, benefits, honoraria, professional fees incurred until voting day Bank charges incurred until voting day Interest charged onloan until voting day Other (provide full details) 1. Business cards 2. Website 3. Website designer ' Professional 5. +� 5931 +� 1. +� 1 +� 3. + $ 1138 +� 6,031.75 C2 + $ Total Expenses subject to general spending limit 5931 Expenses subject hmspending limit for parties and other expressions ofappreciation 1. +$ 1 + $ 3. + $ 4. $ 6,031.75 C2 EXPENSES Expenses subject hmspending limit for parties and other expressions ofappreciation 1. + $ 2. + $ 3. + $ 4. +$ 5. +$ Total Expenses subject tospending limit for parties and other expressions of appreciation = $ C3 9503P (2018/04) Page 2 of 8 Expenses not subject tnspending limits Accounting and audit Cost offundraising events/activities (list details inPart K/ofSchedule 2) Office expenses incurred after voting day Phone and/or inhornotexpenses incurred after voting day Salaries, benefits, honoraria, professional fees incurred after voting day Bank charges incurred after voting day Interest charged nnloan after voting day Expenses related torecount Expenses related bucontroverted election Expenses related $ccompliance audit Expenses related tocandidate's disability (provide full details) 1. _ — 4. 5. Other (provide full details) ' 2. 3. 4. 5. Total Expenses not subject 0ospending limits Total Campaign Expenses pC2+C3+C4 Box D: Calculation of Surplus or Deficit Excess (deficiency) cfincome over expenses (Income minus Total Expenses) (C1—05) Eligible deficit carried forward bythe candidate from the last election (applies Vo2018regular election only) Total (D1—D2) |fthere inusurplus, deduct any refund ofcandidate's or spouse's contributions tuthe campaign Surplus (or deficit) for the campaign +� +� C4 If line D3 shows esurplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerk who is 9503P (2018/04) Page 3 of 8 Schedule I - Contributions Pmd|—SummaryofContrihudonm Contributions inmoney from candidate and spouse Contributions ingoods and services from candidate and spouse (include value listed inTable 3and Table 4) Total value ofcontributions not exceeding *1OOper contributor ` Include ticket revenue, contributions inmoney, goods and services where the total contribution from acontributor io$10Uorless (do not include contributions from candidate orspouoa). Total value of contributions exceeding $100 per contributor (from line I B on page 5; list details inTable 1and Table 2) ~ Include ticket revenue, contributions inmoney, goods and services where the total contribution from acontributor exceeds $10O(do not include contributions from candidate oropouae). Less: Contributions returned or payable tothe contributor Contributions paid orpayable bthe clerk, including contributions from anonymous sources exceeding *25 Total Amount mfContributions (record under Income inBox C) +� +� +� +� = � 1A MartU—Contributions exceeding $100 per contributor—individuals other than candidate mspouse Table 1: Monetary contributions from individuals other than candidate o,spouse Amount * Nome Full Address |Date Recoixmd|AmuuntReceived $| Returned tmConthbutur or Paid to Clerk F-1 Additional information islisted onseparate supplementary attachment 9503P (2018/04) Page 4 of 8 Table 2: Contributions in goods or services from individuals other than candidate or spouse (Note: must also be recorded as Expenses in Box C) Name(Full Address Description of Goods Date Received Value $ 1 or Services I (yyyy/mm/dd) I r-1 Additional information is listed on separate supplementary attachment Total for Part 11 - Contributions exceeding $100 per contributor (Add totals from Table I and Table 2 and record the total in Part I - Summary of Contributions) Part III — Contributions from candidate or spouse Table 3: Contributions in goods or services Total 113 9503P (2018/04) Page 5 of 8 Description of Goods orServices Date Received Value $ FlAdditional information islisted unseparate supplementary attachment Table 4: Inventory of campaign goods and materials from previous municipal campaign used in this campaign (Note: value must be recorded as a contribution from the candidate and as an expense) D000hpUun Date Acquired Supplier Quantity Current Market FjAdditional information iolisted onseparate supplementary attachment 9503P (2018/04) Page 6 of 8 Schedule 2—Pundrelsing Events and Activities FundraisingEv*nt/Activity Complete a separate schedule for each event or activity held [lAdditional oohedule(s)a8aohed Description offundraising event/activity Date ofevent/activity (yyyy/mm/dd Part I—Ticket revenue Admission charge (per person) (if there are a range of ticket p/icoo, attach complete breakdown of all ticket ne|eo) $ 2A Number oftickets sold X 2B Total Part |(2AX 213}(include inPart 1ofSchedule 1) Pmrt||—Othervemanuodoemedonontribution (e.g. revenue from goods sold in excess of fair market value) Provide details 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ Total Part 11 (include in Part 1 of Schedule 1) Part III — Other revenue not deemed mcontribution (e.g. contribution of $25 or |ooe; goods or a*mivan sold for $25 or less) Provide details 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ Total Part III (include under Income in Box C) Pmrt|V—Eupeneesre|atedhofundroioingeventorautivity Provide details 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ G. + $ 7. + $ 8. + $ Total Part |V Expenses (include under Expenses inBox C) 9503P (2018/04) Page 7 of 8 Auditor's Report Municipal Elections Act, 1996 (Section 88.25) 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 (yyyy/mm/dd) Contact Information Last Name or Single Name Given Name(s) Licence Number Address Suite/Unit No. Street No. Street Name un No (including area code) I Email Address 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 F] Report is attached Personal information, ifany, collected on this form is obtained under the authority of sections 88.25 and 95 of the Municipal Elections Act, 1996. Under section 88ofthe Municipal Elections Act, 1Q0O(and despite anything inthe Municipal Freedom ofInformation 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 atotime when the office is open. Campaign financial statements shall also be made available by the clerk in an electronic format free of charge upon 9503P (2018/04) Page 8 of 8