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HomeMy WebLinkAboutBowman, Melissa�l- 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 DO "v"`n"IP"Y MM DD For the campaign period from (day candidate filed nomination) Q, i toD odig �,'hitial 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 -61 ,- __. "I'll Candidate's name as shown on the ballot Last Name or Single Name Given Name(s) Office for which thecandidate sought election Municipality Spending Limit - General W), js lard name or no. Qr pen � Ing Limit - Narties and Utner Expressions i j f7 I did not accept any contributions or incur any expenses. (Complete Boxes A and B only) Box B: Declaration ,declare that to the best of m knowledge .q �„ �„„,f_� _ y g and belief that these financial statements and attached supporting schedules are true and correct. Date Filed (yyyy/mm/dd) t C-) Q C> f andidate or a pe / C1 1 Date (yyyy/mm/ d) or 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 or recognized lending institution NA ���� ..,- r9m� ......� r� Amount borrowed $ INCOME Total amount of all contributions (from line 1A in Schedule 1) + $ S 057.79 m„,_...__. � ...n.............m.m.m.m.m.m.. 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) 1A + $ 2. +$ 4. + $ Total Campaign Income (Do not include loan) $ 5 057.79 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 3 of Schedule 1) + $ Advertising + , 84.65 Brochures/fl ers +�—$ 1,057.92 Signs (including sign deposit) ° 937.90 Meetings hosted 17.77 Office expenses incurred until voting day +' $ 93.13 Phone and/or internet expenses incurred until voting day + $ Salaries, benefits, honoraria, professional fees incurred until voting day +"$ Bank charges incurred until voting day + $ 37 Interest charged on loan until voting day 9 9 + $ Other provide full details) 1. Photography (Erin Watt Photography; headshots) + $ 150.00 2. Website (Weebly.com; webhosting) ","," +$ 0 Equipment(Henry's,. Technical E ui�........ ...... q p ( ty'sLong &McQuade; video) + $ ,,,,,,,,108,,00 121.44 4. Campaign buttons (McDougall Signs) + $ 186.45 . +$ Total Expenses subject to general spending limit $ 3,878.63 c2 EXPENSES Expenses subject to spending limit for parties and other expressions of appreciation 1. Election Day party + $ 416.91 2. Volunteer appreciation (gifts, food) "+ $ m,,,,,,,�::::::::......,........ ....... , 93.33 +$ + $ m Total Expenses subject to spending limit for parties and other expressions of appreciation = $ 50.4C3 9503P (2016/09) 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) + $ 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 +$ 22.85 Interest charged on loan after voting day + $ Expenses related to recount + $ Expenses related to controverted election + $ Expenses related to compliance audit 41 $ Expenses related to candidate's disability (provide full details) 1.. + $ 4. + $ 5. +$ Other (provide full details) 11 +$ 2. + $ 3. $ Total Expenses not subject to spending limits = $ 22.85 C4 Total Campaign Expenses (C2 + C3 + C4) Box DA Calculation of Surplus or Deficit Excess (deficiency) of income over expenses (Income minus Total Expenses) (Cl — C5) Eligible deficit carried forward by the candidate from the last election Total (131 — D2) If there is a surplus, deduct any refund of candidate's or spouse's contributions to the campaign Surplus (or deficit) for the campaign $ 646.07 D1 $ _ D2 $ 6®W7, - $ 646.07 $ D3 $ 4,411.72 c5 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 is responsible for the conduct of the election. 9503P (2016/09) Page 3 of 8 Schedule 1 - Contributions Part I — Summary of Contributions Contribution from candidate (include the value of inventory listed in Table 3) + $ 2,500.00 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)„ + $ 488.16 Total value of contributions exceeding $100 per contributor (from line 113; list details in Tables 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). + $ 2,069.63 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) $ 5,057.79 1A Part II — List of contributions totalling more than $100 Table 1: Monetary contributions from individuals other than candidate or spouse rom,... Full Address � pat,.,, Name a Received m11�... m.......... . ...... Maureen Dinner 168 Schneider Avenue, Kitchener, Ontario, N2GIK8 2018/06/10 Norman Sayer 102 Sunray Avenue, London, �Ontario, N61?IC6 2018/08/18 Jenny Griffin 67 Schneider Avenue, Kitchener, Ontario, N2G 1 K9 1 2018/08/21 Mills 158 Benton Street, Kitchener, Ontario, N2G3H8 1 2018/08/24 Christy Goossen 1008 Queen's Boulevard, Kitchener, Ontario, 2 1 2018/09/23 Heather Campbell 488 Lexington Crescent, Waterloo, Ontario, N2K2J8 2018/10/15 Tony Dibattista 195 King Street Nest, Suite 201, Kitchener, Ontario, N2G I B 1 1 2018/10/20 0 Additional information is listed on separate supplementary attachment Total Amount $ 150.00 200.00 500.00 1.50.00 200.00 500.00 200.00 9503P (2016/09) Page 4 of B 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 $ or Services (yyyy/mm/dd) Mary Bowman 14-100 Idle Creek Drive, �rvrvrvrvmmnnnnn,,, rvrvrv�. food purchases m. mn .,n,,,,, ,mm.,,.rn� ----- Kitchener, On, N2A4H3 (election party) 201 x/10/22 169°63 Debra Klippenstein 4 Kent Street RR#4, chocolates (volunteer Blenheim, On, NOP I AO gifts) 2018/10/22 37,22 :d- l 'owrt(an 2$5 Pandora Ave, Kitchen" er° °, ...�,,,, fo od urchas es On, N2H3E4 (election party) 2018/10/22 50°94 ....ti �. © Additional information is listed on separate supplementary attachment Total 257.7 Total Part 11- Contributions (Add totals from Table 1 and Table 2) (Record in Part 1 - Summary of 2158 113 Contributions) Part III — Inventory Table 3: 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 �YYYY mm dd) Supplier 111111111 Q 11 uantity 9 jValue $Market 9503P (2016/09) Page 5 of 8 Description Date Acquired Supplier (yyyy/mm/dd) Additional information is listed on separate supplementary attachment Quantity Total Current Market Value $ 9503P (2016/09) Page 6 of 8 Schedule 2 — Fundraising Events and Activities Fundraising Event/Activity Complete a separate schedule for each event or activity held Additional schedule(s) attached Description of fundraising event/activity Date of event/activity (yyyy/mm/dd) Part I — 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 Total Ticket Revenue (2A X 213) (include in Part 1 of Schedule 1) Part II — Other revenue deemed a contribution (e.g. revenue from goods sold in excess of fair market value) Provide details 1I .,.,,,..:rrrrrrrrrrrr 4. Total Part 11 Revenue include in Schedule 1 + $ 2A X ,......�.........................:. 2B Part Ill — Other revenue not deemed a contribution (e.g. contribution of $25 or less; goods or services sold for $25 or less) Provide details 1M + $ 2. + $ 3. + $ '. + Total Part III Revenue (include under income in Box C) Part IV — Expenses related to fundraising event or activity Provide details 1 2. ........., :.......................................... 3 4. g. ................. m..... ........ , ..-- —,,,,,,,, ... v, Total Part IV Expenses (include under expenses in Box C) M M 9503P (2016/09) 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 Last Name Address Suite/Unit No. Street No, Street Name ni area code) The report must be done in accordance with generally accepted auditing standards and must: ® set out the scope of the examination (yyyy/mm/dd) Licence Number provide an opinion as to the completeness and accuracy of the financial statement and whether it is free of material misstatement m, ... mmm................................ Report is attached Code 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 (2016109) Page 8 of 8