bc.v-c.b dtt, ~ o ) S t?ontario l8j Primary filing reftecting finances to December 31 (or 45" day after 110ting day in a by~ection)
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1 ~ t?ontario Mlnlaby of Munlclpal Affairs ndhouslng Financial Statement - Auditor's Report Form4 Municipal Elections Act (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. An 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 DO yyyy MM DD For the campaign period from (day candidate filed nomination>!. 20_1_4_... 0_9_... o_j, to l8j Primary filing reftecting finances to December 31 (or 45" day after 110ting day in a by~ection) 0 Supplementary filing including finances after December 31 (or day after lloling day in a by-election) Box A: Name of Candidate and Office Candidate's name as shown on the bauot Last Name Lambert Name of office for which the candidate sought election French-Language, Catholic School Board Trustee Given Name(s) Olga Ward name or no. (if any) Name of Municipality Durham, Peterborough, Kawartha, Clarington Spending limit issued by clerk S8,44 J.65 0 I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and 8 only) Box B: Declaration I, Olga Lambert a candidate m the munlcipality or _D_u_rh_a_m hereby declare that to the bast of my knowledge and belief that these financial statements and attached supporting schedules are true and correct Declared before (clerk or commissioner) inthe (,,.~ Q~ ~~ "- } on (yyyy/mmldd) M Q.c(J... ci~1 d 0 15" ~- Signature of Clerk or Commissioner bc.v-c.b dtt, ~ o ) S Date Filed in the Clerk's Office (yyyy/mmldd) 9503P (2013/11) 0 <lue«t' Pnntllf ' ' Onlario Ditpooil:Jle en ~is Page 1 ot9
2 ...;;..;..;,.;~ Box C: Statement of Campaign Income and Expenses LOAN Other (provide full details) 1. bank account closing fee Total Campaign Income (Do not Include loan) Not Applicatble Name of bank or recognized lending institution Amount botrowed S_ 0.00 _..;;.. INCOME Total amount of all contributions (From line 1A in Schedule 1) +...;;. s..4.;.;.0;..;:5;... 4;...; Refund of nomination filing fee + -=- s ;l;..;:0:.:: 0.:.:.00 ::.::... Sign deposit refund + _;;_s Revenue rrom fund-raising events not deemed a contribution (From Part Ill of Schedule 2) + ---'- S Interest earned by campaign bank account + _;;_s --= 0..:.:.00 ;...;;._ EXPENSES (Note: include the value of contributions of goods and services) Expense subject to spending limit Nomination filing fee Inventory rrom previous campaign used in this campaign (list details in Tables of Schedule 1) Advertising Brochures/flyers Signs (including sign deposit) Meetings hosted Office expenses incurred until voting day Phone and/or Internet expenses inq,med unbl voting day Salanes. benefits, honoraria, professlonal fees incurred until voting day Bank charges incurred until voting day Interest charged on loan until voting day Other (provide full details) 1. ~ ~ s _s_ =2 '---~~ Total Expensea subject to spending llmlt Expenses not subject to spending limit Accounting and audit Cost of fund-raising events/activities (fist details in Part IV of Schedule 2) Voting day party/apprecia1ion notices Office expenses mcurred after voting day Phone and/or lntemet eicpenses incurred after voling day Salaries, benefits, honoraria, professional fees incurred after voting day Bank charges incurred after voting day Interest charged on loan after voting day Eicpenses related to recount Expenses related to controverted election Expenses related to compliance audit Expenses related to candidate's disability (provide full details) 1. + _;;_s --= ;..;:;._ + -=-s + _... s = s C1 +...:. S,1:...:00:.;::.:.;.0:..:0~ + _;;_s --"o..;...o;...;o;,.._ + -=- s...::0:.:..:.00 :..:~ + -=- S..:...:..:..: :..:~ + -=- s-----= 0;.:..;.00 :..:~ + s"-- o""'.q'""o_ + _"--- s =-.0 0.:..::=0 +...:. S ;::0.:.:.00 :..:~ + -=- s ;:: 0.:.::...:~ =- s...:: 0.:.:.0:...:~ ;:;. s = $ + $ $ 3. Other (provide full details) _ C $ 0.00 s 0.00 s $ O.OQ_ 9503P{2013/11) Paga 2 o/ 9
3 Total Expenses not subject to spending limit = s 0.00 C3 Total Campaign Expenses (C2 + C3) = s C4 9503P ( J Page 3 of 9
4 Box D: CalcufaUon of Surplus or Deficit Excess (deficiency) of income over expenses (Income - Total Expenses) (C1 -C4) + $ Eligible deficit carried forward by the candidate from the last election - $ Total (01-02) $ o.oo If there is a surplus, deduct any refund of candidate's or spouse's contributions to the campaign - s Surplus (or deficit) for the campaign = $ If line 03 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerl< who was responsible for the conduct of the election. Amount of _s paid to municipal cleric in the municipality of P ( ) Page 4 of 9
5 Schedule 1 - Contributions Part 1-Summary of Contributions Contribution from candidate (include the value of inventory listed 1n Table 5) Contribution from spouse 0.00 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) Total value of contributions exceeding $100 per contributor (from line 18; 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) Leas: Contributions returned or payable to the contributor - s 5.95 Contributions paid or payable lo the clerk, lnduding contributions from anonymous sources exceeding $1 0 - s 0.00 Total Amount of Contributions (Record In Box C) = s 44.0S 1A Part II-Ust of Contributions from Each Single ContrlbutorTotalllng more than $100 Table 1: Monetary contributions from Individuals other than candidate or spouse Name Full Address Amount$ 0 Additional information is listed on separate supplementary attachment Total P ( ) Page 5 of 9
6 Table 2: Monetary contributions from corporations or unions Name (Legal and Carrying on Business As) Full Addreaa President or Business Manaaar Authorized R l>f'89 ntative Amount$ 0 Additional mfonnatlon is hsted on separate supplementary attachment Total 0.00 Table 3: Contributions In goods orservices from lndlvlduala otherthan candidate orspouse fnote: must also be reeorded as exnanses In Box Cl Name Full Address Description of Goods or Service Value$ 0 Addibonal infonnation is listed on separate supplementary attachment Total P ( ) Page 6 ofll
7 Table 4: Contributions In aooda or services from comoratfona or unions 'Note: must also be recorded as expansea In Box Cl Name ofcorporation Full Address President or Authorized Description of Value$ (Legal and Carrying on Busln" Manager Representative Goods or Services Business As) 0 Additional informallon is listed on separate supplementary attacivnent Tobi I Total Part II Contributions (Add Totals from Tables 1""'4) (Record in Part I - Summary) $ Part Ill - Inventory Tabla 5: Inventory of Campaign Goods and Materials from Previous Campaign used In this Campaign (Note: value must be recorded aa a contribution from the candidate and as an expanh) Description Impression de pamphlets/ printing offlyer Date Acquired (yyyy/mmldd) 2015/10/l l Supplier Staples Copy & Print - 16 Harwood Ave S. Ajax On Currant Mart<et Value S Quantity Total Value$ 0.78 each+tax Additional information is listed on separate supplementary attachment Total P ( ) Page7 ol 9
8 Schedule 2 - Fundraising Events and Actlvitles Fundralelng Event/Activity Complete a separate schedule for each avant or activity held 0 Additional schedule(s) attached Description of tundra1sing event/activity Date of event/activity (yyyy/mmtdd) No activity of Fundraising was conducted Part I - Ticket Revenue Admission charge (per person) (If there are a range of ticket prices, attach complete breakdown of all ticket sales) + -.::. s 2A Number of tickets sold X 28 Total Ticket Revenue (2A x 2B) (Include In Schedule 1)...;;...;;;.;..;;..;;;_ S 0.00 Part II - Other revenue deemed a contribuuon (provide details (e.g. revenue from goods sold in excess of fair market value)) ;;. s ~ 2~- + $ ~. 3_ ~ $ _4 _. 5. Total Part II Revenue (Include In Schedule 1) Part Ill - Other revenue not deemed a contribution (provide details (e.g. conlribulions of $10 or less; mat1<et value of goods or services sold)) 1. + _s' Total Part Ill Revenue (Include In Box C) s 0.00 Part IV - Expenlft related to fundralalng event or activity (provide details) 1. N/A + _;;, s ;;.._ $ ;;.._ $ _ 4~~ ~ ~ $ ~ s~ s ~ 6~ s Total Part IV Expenses (Include In Box C) s P ( ) Page Bof 'ii
9 Auditor's Report Municipal Elections Act, 1996 (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 IDate (yyyy/mm/dd) Contact Information Name Last Name Address Suite/Unit No. Street No. Street Name IFirst Name IUamce """""' CityfTown Province Postal Code Telephone No. (Including area code) Fax No. e>ct. 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 matenal misstatement D 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, Under section 88 of the Municipal Elections Act, 1996 (and despite anything in the Municipal Freedom oflnfonnation and Protection ofprivacy Act) documents and materials filed with or prepared by the clerk or any other electlon 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 clef1< in an electronic fonnat free of charge upon request 9503P ( ) Page 9 ol 9
Financial Statement - Auditor's Report Candidate - Form 4
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