HomeMy WebLinkAboutJohnston, Margaretj�- Ontario Ministry of Municipal Affairs Financial Statement - Auditor's Report
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 da candidate filed nomination to
P� (day ) 2 0 1 8 0 5..� 0 3� 2 0 _.� 8 1 1 2.] .3 1.
0✓ Initial filing reflecting finances to December 31 (or 45 days after voting day in a by-election)
0 Supplementary filing including finances after December 31 (or 45 days after voting day in a by-election)
Box A: Name of Candidate and Office
Candim,.,.,....... � � _ , ...,..
date's name as shown on the ballot
Last Name or Single Name Given Name(s)
John ton Margaret
Office for wh �...
Councillor
municipality
Kitchener
e candidate sought election
I
name or no. (if any
openaing Limit - uenerw Spending Limit - Parties and Other Expressions of Appreciation
$ 17,376.00 $ 1737.60
Q 1 did not accept any contributions or incur any expenses. (Complete Boxes A and B only)
Box B: Declaration
I, Margaret John
statements and ag%ache supporting schedyltes are true and correct.
� I / 0 Gs< I Li "
IN
Initial
, declare that to the best of my knowledge and belief that these financial
or Agent (if filed in
Date (yyyy/mm/dd)
of Clerk or Designate
9503P (2018/04) p Queen's Printer for Ontario, 2018 Disponible en franpais Page 1 of 8
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) + $ 5716.70
Revenue from items $25 or less + $
Sign deposit refund + $
Revenue from fundraising events not deemed a contribution (from Part III of $
Schedule 2) "— —«
Interest earned by campaign bank account + $
Other (provide full details)
1„ + $
2. "--'....�,......„ .... ...... - ...- ,. + $
3. + $
4. + $
5+ $
TotalCampaign Income ... (��,,.
Do not include loan) = $ 5,716.70 C1
EXPENSES (Note: include the value of contributions of goods and services)
Expenses subject to general spending limit
Inventory from previous campaign used in this campaign (list details in Table 4 of
$
900.00
Schedule 1)
+
••:
Advertising
+ $
775.37
Brochures/flyers
+ $
1,289.36
Signs (including sign deposit)
$ 03
909.65
Meetings hosted
+
Office expenses incurred until voting day
+ $
81.36
Phone and/or internet expenses incurred until voting day
+ $
_
Salaries, benefits, honoraria, professional fees incurred until voting day
+ $
500 00
Bank charges incurred until voting day
+ $
34.75
Interest charged on loan until voting day
+ $
Other (provide full details)
1. Paypal Charges
+ $
73.07
2. Bank Charges -`aft r voting day+
.
$
—
13.90
3. Treats for festival
+
�
..,
w.�...
4. Flyer Delivery
.,...,,,,,,..
536.75
5. Photography,
+ $
226.00
Total Expenses subject to general spending limit
- $
5,346.53 C2
EXPENSES
Expenses subject to spending limit for parties and other expressions of appreciation
1+$
2. �,�
�� . + $
.... . . __ .,.: ......� ��
3.
.+ . ........
4.+
$
5
" it �
+ $
_
Total Expenses subject to spending limit for parties and other expressions
of appreciation
$ 03
9503P (2018/04)
Page 2 of 8
Expenses not subject to spending limits
Accounting and audit
+
$
Cost of fundraising events/activities (list details in Part IV of Schedule 2)
+`$
244;
Schedule 1 - Contributions
----................ ......... ................................ ......,,..m
Part I — Summary of Contributions
._._________.........
Contributions in money from candidate and spouse
+ $ 657.70
Contributions in goods and services from candidate and spouse
(include value listed in Table 3 and Table 4)
+ $ 900.00
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).
+ $ 809.00
Total value of contributions exceeding $100 per contributor (from line 1 B on page 5;
list details in Table 1 and Table 2)
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 $25 —
Total Amount of Contributions (record under Income in Box C) $ 2,366.70 1A
Part II —Contributions exceeding $100 per contributor— individuals other than candidate or spouse
Table 1: Monetary contributions from individuals other than candidate or spouse
Name I Full Address
Amount $
Date Received Amount Received $ Returned to Contributor
�or Paid to Clerk
Alexandra Piatkowski 44 Katherine Crescent,
Kitchener, ON, N2M 2K1 2018/08/26 200.00
IatKOwSKI 44 Katnerine Urescent,
Kitchener, ON, N2M 2K1 2018/08/31 500.00
Tom Warriner 31 Erindale Drive, Erin, ON,
NOB 1 TO 2018/09/30 100.00
r Campbell c/o 1020 King St E,
Kitchener, ON N2G 2M9 2018/10/16 500.00
ally Ryan 303 Brimson Dr.,
Newmarket, ON, L3X1J1 2018/10/17 150.00
Ido Battista c/o 195 King St W Unit 201
Kitchener, ON N2G 1B1 2018/10/17 200.00
Duncan McLean Dick Street, Waterloo,
N243, N2L 1N3 2018/10/22 250.00
Timothy Flannery c/o 82 Weber St E,
Kitchener ON N2H 1 C7 2018/09/14 100.00
Walter McLean 424-139 Father David Bauer
Drive, Wloo, ON N2L 61_1 2018/08/30 100.00
Additional information is listed on separate supplementary attachment Total 2,100.00
9503P (n18104)
Page 4 of 8
Schedule 1 -Contributions
—.� :....._ x...... ... .... ......... ......_ __. ..., ........... ..... __.._.......... _... .............. .......
Part I - Summary of Contributions
Contributions in money from candidate and spouse $
Contributions in goods and services from candidate and spouse
(include value listed in Table 3 and Table 4) + $
.....................
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 on page 5,
list details in Table 1 and Table 2)
w 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 $25 $
Total Amount of Contributions (record under Income in Box C) m $ � � 1
Part II - Contributions exceeding $100
per contributor - individuals other
than candidate
or spouse
Table 1: Monetary contributions from
individuals other than candidate
m�..... .........-
or spouse
______... ....
Amount $
Name
Full Address
Date Received
Amount Received $
Returned to Contributor
or Paid to Clerk
w.. ..................
.. ,
Shnei,,
usan Cade ll
21 .Sc.._.,,,, ,der Ave.
.....
-........� -, ,.
,--, . ,,,,,,,
Kitchener, ON
2018/08/30
100.00
N2G 1 K7
........ ..... ........
Susan Filiatrault
- . ......... ........ ......__._ W
67 Windrush Trail
. , mm .........................
.«. ....... ......._
Kitchener, ON
2018/08/30
100.00
N2P 2A8
Jane Harding
12 Michael St.
Kitchener, ON
2018/09/06
100.00
N2G 1 L8
.........
Carly Greco
.......................... ....., ,,,,,,,.
88 Dekay St.
................................ _.
_...
Kitchener, ON
2018/08/30
100.00
N2H 3T6
.........
Valerie Bradford
., .......... _ _._ ..
102 Deer Ridge Dr.
........................... _
. ....... _
_...... .........
Kitchener, ON
2018/07/27
100.00
N2P 2K9
Catherine Fife ,,._
e
......
21 Menno St. Waterloo, ON
N2L 2A4
2018/08/30
200.00
Ian McLean
.� ..........W
196 -Hilliard'Av_..'_a e. Watee rloo,
__ ..
ON N2L 1G1
2018/08/30
100.00
_L_.
Vaughn Bender
30 Weberlyn Cres.
._.._..
.......... ............, .....
Conestogo, ON NOB 1N0
2018/11/15
100.00
�� ,...
Brad Schlegel
............. ___.... _ _...... ,,, „ . .......�.
35 Frey Cres. Kitchener, ON
_..._... . ..........
__-- . ����
N2E 41-6
2018/11/15
100.00
✓ Additional information is I„,,,��....
sted on separate
supplementary attachment
Total
_ _ .,,,�
1,000.00'
9503P (2018/04)
............. _
Page 4 of 8
Schedule 1 -Contributions
_...._ . __ .._................... ............................................................. ......_._.......
Part I — Summary of Contributions
Contributions in money from candidate and spouse +
Contributions in goods and services from candidate and spouse
(include value listed in Table 3 and Table 4) + $
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), 4, $f
Total value of contributions exceeding $100 per contributor (from line 1 B on page 5„
list details in Table 1 and Table 2)
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 $25 -M
( ).........
.............................................
Total Amount of Contributions record under Income in Box C _ 1A
Part II — Contributions exceeding $100 per contributor — individuals other than candidate or spouse
Table 1: Monetary contributions from individuals other than candidate or spouse
Name I Full Address
James Schlegel C/O 325 Max Becker Drive
Kitchener, ON N2E 41-15
Barbara Schlegel 325 Max Becker Drive
Kitchener, ON N2E 4H5
Ron Schlegel 325 Max Becker Drive
Kitchener, ON N2E 4H5
❑ Additional information is listed on separate supplementary attachment
Amount $
Date Received Amount Received $ Returned to Contributor
�or Paid to Clerk
2018/11/19 1 100.00
2018/11/15 ( 100.00
2018/11/15 1 100.00
Total 300.00
9503P (2018104) 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
or Services
7 Additional information is listed on separate supplementary attachment
(yyyy/mm/dd)
Total for Part II - Contributions exceeding $100 per contributor
(Add totals from Table 1 and Table 2 and record the total in Part 1 - Summary of Contributions)
Part III - Contributions from candidate or spouse
Table 3: Contributions in goods or services
Total
Value $
$1 2,100.001 B
r-1, Additional information is listed on separate supplementary attachment
9503P (2Q18/Q4) Page 5 of 8
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)
Description
an
Date AcquiredI Supplier
(yyyy/mm/dd)
[] Additional information is listed on separate supplementary attachment
ra
Quantity Current Market
Value $
00 II 900.00
Total nj 900.00
9503P (2018/04) Page 6 of 8
Schedule 2 — Fundraising Events and Activities
Fundraising Event/Activity
Complete a separate schedule for each event or activity held
0 Additional schedule(s) attached
Description of fundraising event/activity Campaign Kickoff
Date of event/activity (yyyy/mm/dd) 2018/08/30
Part 1— Ticket revenue
Admission charge (per person)
(If there are a range of ticket prices, attach complete breakdown of all ticket
sales)
Number of tickets sold k
Total Part I (2A X 213) (include in Part 1 of Schedule 1)
Part III — Other revenue not deemed a contribution
(e,g. contribution of $25 or less; goods or services sold for $25 or less)
Provide details
................................................................................. _.
$
20.62
* $
128.57
5.64
.,� $ .._......................_
89.80..
............................. ._
2A
213
M
W
244.63
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
Contact information
Date (yyyy/mm/dd)
Last Name or Single Name I! Given Name(s) I Licence Number
Address
Suite/Unit No, Street No. Street Name
pa
Telephone 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
[] Report is attached
Personal information, if any, collected on this form is obtained under the authority of sections 88.25 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 (2018/04) Page 8 of 8