CAMPAIGN FINANCING DISCLOSURE STATEMENT FOR THE 2011 GENERAL ELECTION (COUNCILLOR)

Transcription

1 Local Government Act Section 90 CITY OF NANAIMO CAMPAIGN FINANCING DISCLOSURE STATEMENT FOR THE 2011 GENERAL ELECTION (COUNCILLOR) Form 3-9b This disclosure statement is to be filed with the Manager of Legislative Services of the City of Nanaimo within 120 days after the local general election voting day (March 19, 2012). Disclosure statements may be filed from March 20 1 h, 2012 until April18 1 h, 2012 on payment of a $500 late filing penalty to the City of Nanaimo. NAME OF OFFICE for which the candidate sought election: -----"'C:..:::O::.--=U::.!.N~C~I=LL=O=R'-.!...- -,-- NAME OF ENDORSING ELECTOR ORGANIZATION (if applicable): SUMMARY OF CAMPAIGN CONTRIBUTIONS Total amount of campaign contributions Total of (A, B & C) from Schedule A: Part 1 (page 4) $ 300.aa List of contributors who made contributions totalling $100 or more Complete Schedule A: Part 2 (page 5) Total amount of anonymous campaign contributions remitted to the City of Nanaimo Total from Schedule A: Part 3 (page 6) NAMeoFcANDIDATE:~J~A~H~~~A~N~~tl~o~N_Y~-~K~I~P~P~~~~- $~..u~- - SUMMARY OF ELECTION EXPENSES Total amount of election expenses COMPLETE SCHEDULE 8 (page 7) $ SURPLUS FUNDS Transfer from local government (surplus funds from previous election) Balance (positive or negative) remaining in candidate's campaign account $ -e._ $~-e=---- COMPLETE SCHEDULE C (page 8) CAMPAIGN ACCOUNT INFORMATION All monetary contributions were deposite~ i'}yand all election expense~ p~id from an account O!Jened for this purpose at CoASTAl Caanmu.~ H Y c.u. located at 1\ t-59 Wt±Aff Sr. NAtJAtf"lD (name of financial institution) (Branch address) NOTE: This is not a balance sheet. For example, contributions may not equal expenses. COMPLETE THE APPROPRIATE DECLARATIONS ON PAGES 2 AND 3 Page 1 of 13

2 DECLARATION OF CANDIDATE I,.T A H ES ANT»6 N ~ K I PP, a candidate for COUNCILLOR in the City of Nanaimo election, solemnly a f1rm that to the best of my knowledge, 1nformat1on and belief: (a) (b) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo; and the requirements of Division 8- Campaign Financing of the Local Government Act have been met in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo. Declared before me at --=-N.::...:... A_N.:.f+_l_M~O=--- British Columbia this 1- day of -----'-M~A~~--=..::C=..li..._., 201 ~ Desi nat d Local Government Officer or Com s ioner for taking affidavits for British Columbia DECLARATION OF ELECTOR ORGANIZATION OFFICIAL (it applicable) I,, being the -----::7.7--:----::---:-----:-...z-:-::----- (title of authorized icial) for the ,----.,----,----.,.-,--, ' solem y affirm that to the (name of elector organization) best of my knowledge, information and belief: (a) (b) this campaign financing disclosure statement and surroorting schedules completely and accurately discloses the information required by Sec,.r!9o of the Local Government Act for the election campaign of (na9e of candidate) for the office of COUNCILLOR in the 2011 local genef al election for the City of Nanaimo; and the requirements of Division 8 - Campaign F ~fncing of the Local Government Act have been met in relation to the election campaign of--''- ' for the office of COUNCILLOR in the 20 ~ 1 local general election for the City of Nanaimo. Declared before me at ,-"----' British Columbia this day of-----,..:;., 201. Designated Local Government Officer or Commissioner for taking affid9vits for British Columbia Signature of Elector Organization Official Page 2 of 13

3 DECLARATION OF CAMPAIGN ORGANIZER (!fa~~ Form 3-9b I, -~ ' being the -----;:-:7.'"--:---::---:---:--:::::-:-::----- ) tifle of authorized official) for the.,..., solemnly affirm that to the (name of elector organization) best of my knowledge, information and belief: (a) (b), this campaign financing disclosure statement and supporting schedules completely and accurately discloses the informationjequired by Section 90 of the Local Government Act for the election campaign of ----r ,----.,---::-:---, (name of candidate) for the office of COUNCILLOR ia the 2011 local general election for the City of Nanaimo; and the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to th~ election campaign of for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo. Declared beforeme at, British Columbia "' this L ~ay of, 201_. Designated Local Government Officer or Commissioner for taking affidavits for British Columbia Signature of Campaign Organizer DECLARATION OF FINANCIAL AGENT I,~~~~~~ ~~~~~S ~~~~~ ~~~~~~~ have prepared this disclosure statement and supporting schedules for ----:7"7'J=--!-A-'-:-M~E.:=S'"---:'A!...!:'-N...;_T"--'-80~N_.... 'i_~l( -=--::- l._f 7 P---:-:-:- name of candidate (or elector organization or campaign organizer, if applicable) and solemnly affirm that to the best of my knowledge, information and belief that: (a) (b) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to the election campaign of.:tf\m.os ANTrtof't)' Kl P P (name of candidate) for COUNCILLOR in the 2011 local general election for the City of Nanaimo; and the requirements of Division 8 - Campaign Financing of the LQcal G<:._~ernment Act have been met in relation to the election campaign of ;ram t: S ANTHOr" Y \L \ PP (name of candidate) for COUNCILLOR in the 2011 local general election for the City of Nanaimo. Declared before me at th is ----=-- f0 AtJ A-l M b, British Columbia day of ~M.:..._:..o.{} _,_Q'--=--= e_::...:... L-t, 201 ~. Desi nat d Local Government Officer or Com s ner for taking affidavits for British Columbia Page 3 of 13

4 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART1: CONT~BUTIONS Contributions from known sources Total value of contributions of $100 or more from a single source {A) $ Unless nil, complete Schedule A: Part 2 (page 5). Total value of contributions totalling $99.99 or less from a single source (B) $ Contributions from anonymous sources Contributions from anonymous sources $ :::::::... LESS: value of anonymous contributions over $50 remitted to the City of Nanaimo (Total from Schedule A: Part 3- page 6) $4 Total value of anonymous campaign contributions of $50 or less = (C) $ --'d, ', 3 00 TOTAL VALUE OF CONTRIBUTIONS (A+ B +C)= $ '- 00. Total number of contributors who made contributions totalling $99.99 or less Page 4 of 13

5 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART 2: LIST OF CONTRIBUTORS TOTALLING $100 OR MORE from Item (A) (page 4) * 1 * FULL NAME * 2 * ADDRESS DATE AMOUNT (if applicable) Jt:tMGS I<!.JPP CtJtJ't:>lbA J 5 * 3 * CLASS 1J CoN Tk l ~ ( 1-rl OJ Ou. l'tt, '" I TOTAL I I l3oo(.(}l Attach supplementary list 1f requ1red I *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. *3* Classes: individual, corporation, unincorporated organization, trade union, non-profit organization, other. Page 5 of 13

6 CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS SCHEDULE 'A' PART 3- LIST OF ANONYMOUS CONTRIBUTIONS OVER $50 REMITTED TO CITY OF NANAIMO DATE VALUE 0 DATE VALUE e- SUB-TOTAL 'JJ. \.._ SUB-TOTAL.r\_ '-... GRAND TOTAL Page 6 of 13

7 Local Government Act Section 90(4)(f) BC. Reg Form 3-9b CAMPAIGN FINANCING DISCLOSURE STATEMENT SCHEDULE 'B' ELECTION EXPENSE DETAILS A. Election campaign advertising or communication expenses for: (1) radio, television, newspaper, magazine or electronic advertising for the public (2) signs, pamphlets, flyers and brochures (3) advertising and promotion for the public not included in A(1) or (2) above (4) newsletters for members of the elector organization $ LJ(J. 00 $ 13:<. 72 $ et $ B. Election campaign office expenses for: (1) compensation paid to persons for campaign work, other than for services described in Section 89(2) of the Local Government Act (2) rent, insurance and utilities (3) courier services and postage (4) furniture, telecommunication equipment and other equipment (5) office supplies and other office expenses not covered by 8(1) to (4) above C. Convention and similar meeting expenses D. Expenses for campaign related functions not described inc above E. Research and polling expenses F. Campaign related transportation G. Other expenses (provide description) Ba()K chatges: ocr a; Nov.3o De0 3j + t os e.ot.d- :l.. 51 TOTAL AMOUNT OF ELECTION EXPENSES $ 17 $ ; _ $ Ia $,0"'----- Total amount of other expenses $ $ 0, $ $ r""' $ -e- f~- ~' $ -e $ e- $ B $ ~ $_7-:_._ $ :300. Page 7 of 13

8 Local Government Act Section 90(4) Form 3-9b CAMPAIGN FINANCING DISCLOSURE STATEMENT SCHEDULE 'C' DETAILS OF SURPLUS FUNDS DISBURSEMENT A. B. C. Balance remaining in account Amount reimbursed to candidate from campaign account for the candidate's contributions to hisher campaign Amount of remaining surplus funds (after any reimbursement under B.) $...:; $ $======-== D. Details of the disbursement of remaining surplus funds under C. Page 8 of 13

9 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF CASH CAMPAIGN CONTRIBUTIONS * 1 * FULL NAME *Z*ADDRESS DATE AMOUNT * 3 * CLASS (if applicable) e- I TOTAL I I I e-1 I *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. *3* Classes: individual, corporation, unincorporated organization, trade union, non-profit organization, other. Page 9 of 13

10 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF IN-KIND CAMPAIGN CONTRIBUTIONS 13?A+JPON 1. NAME z ADDRESS DATE GOOD or VALUE (if applicable) SERVICE No 1 3 f J 1-=1- ;}_() k1pp Serv,'ce Nov 3) 4 PAMELA JA~Gf<. serv.cc_ los' rjov 3, l..f AP.RorJ -! ALJ kin S Sef'\lt~!05' RAND 'I LJrrL~ NoV ll suv1ce.., 5"0 BJ<fltJ b 0 tj Lt TTL Nov it Ser-V(C~ 50, ~o"?, {g J J u. L l A- l<.ut(:-ra 'SeJ'II ce. 50 Gj Nov5.t,. JiM KJPP 1 ~ I -=z 2C'l servt'ce.. 1~ 0 J'iM I<!Pf ~ve.. a:s J ' +~acje-( 100 TOTAL {}80.0() *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members. *2* Do not report addresses of individuals. Page 10 of 13

11 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF DISCOUNTED GOODS AND SERVICES GOOD OR SERVICE PRICE PAID FAIR MARKET VALUE (RETAIL VALUE) KtPP Fnt< Cou.NCJ.L. ~\tr...i\js Pt ev t"ou.s co.moru'q~ ~00 00 'U TOTAL ' {;OQ. oo Page 11 of 13

12 CAMPAIGN FINANCING RECORD KEEPING FORM CAMPAIGN CONTRIBUTIONS RECORD OF ANONYMOUS CAMPAIGN CONTRIBUTIONS $50 OR LESS CONTRIBUTION VALUEAMOUNT DATE REMITTED TO LOCAL (MONEY, GOODS) (if greater than $50) GOVERNMENT f3_ \.) TOTAL '1 '"-" Page 12 of 13

13 CAMPAIGN FINANCING RECORD KEEPING FORM RECORD OF ELECTION EXPENSES GOODS, PROPERTY OR SERVICES DATE DATE AMOUNT RECEIVED INCURRED PAID B R.O Wu.f( 6-S tjov ~)Lt Jov 3 It 3~.72. W&BPA-(;E -ltbb OJJ Nov tr 11 Van!s-12 l..f{)oo Coas-1-aJ Co I"YJ YY1 un fj, AAtJ lt.. ~1-fll--i<~ OC:r-Ft.B_ ae..r- p._efj J..7: 28' TOTAL Page 13 of 13