FORM 4 REFERENCE: SECTION 21(1)

Transcription

1 AMPAIGN EXPENSES AND ONTRIBUTIONS BY-LAW NO AUDITED FINANIAL STATEMENT REFERENE: SETION 21(1) THE ITY OF WINNIPEG FORM 4 $ 16.7 ampaign Period Surplus (Deficit) ((A) - (B)) $ 4,45.27 (B) Total Period Expenses $ 41,466 (A) Total ampaign Income ampaign Expenses Subject to Limitation (as per Statement of Income and Expenses) $ $ ampaign Expense Limitation (as per form ) SUMMARY OF AMPAIGN INOME AND EXPENSES ouncillor St. Norbert OFFIE WARD NAME (IF OUNILLOR ANDIDATE) FAXNUMBER PHONE ALTERNATE ITY, PROVINE Winnipeg, MB POSTAL ODE ADDRESS ADDRESS NAME OF REGISTERED ANDIDATE Janice Lukes NAME OF ANDIDATE AND OFFIE -Jun-14 1-Mar-15 For the campaign penod From To By-law No. 1/21 Form 4 - Audited Financial Statement - I D 1 of 14

2 Name of andidate Janice Lukes hereby declare that DELARATION OF ANDIDATE Signature of ampaign Expenses and ontributions Officer Signature of Official Agent JL /y tz dayof /9/ 7 2/ I Declared before me at the ity of Winnipeg in the Province of Manitoba this as if made under oath. and correct and I make this declaration conscientiously believing it to be true and knowing that it is of the same force and effect declare that to the best of my knowledge and belief this Financial Statement and supporting schedules as set out herein are true and supporting schedules as set out herein for Janice Lukes and hereby Name of andidate Name of Official Agent on-lee Paterson have prepared this ampaign Period Return DELARATION OF OFFIIAL AGENT // day of Declared before me at the ity of Winnipeg in the Province of Manitoba this I make this declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath. to the best of my knowledge and belief this financial statement and supporting schedules as set out herein are true and correct and By-law No. 1/21 Form 4 - Audited Financial Statement - 2 of 14

3 Released by the Senior Election Official andidate s Surplus from immediately preceding Election $ INOME FROM /6/214 TO 1//215 STATEMENT OF INOME AND EXPENSES SUB-TOTAL AMPAIGN EXPENSES SUBJET TO LIMITATION $ Advertising $ 9,28.96 Bank harges $ 456. Travel $ Robocall, Phone bank, Web design, T-shirts andidate s Personal Expenses $ Other (Please Specify): $ 4,86.49 Telephone $ Furniture $ Meetings, Social Functions, Rallies $ 1,45.27 Stationery Office Rent $ 75 Office Supplies $ Insurance and Utilities $ AMPAIGN EXPENSES SUBJET TO LIMITATION (ATTAH SHEDULE 4; IF ANY DISPUTED LAIMS, ATTAH SHEDULE 5) EXPENSES Brochures $ 9,42.16 Salaries and Benefits $ 4, Signs $ 6,584.7 Postage $ TOTAL INOME $ Interest Income $ Fund-Raising Event (attached Schedule 2) $ Other (Please Specify): $ ontributions (attached Schedule 1) $ 41,466 By-law No. 1/21 Form 4- Statement of Income and Expenses - of 14

4 AMPAIGN EXPENSES EXLUDED FROM LIMITATION Sub-total ampaign Expenses Subject to Limitation $ 9, $ 41,466. Total Income (reported from previous page) STATEMENT OF INOME AND EXPENSES (continued) 4 of 14 AMPAIGN PERIOD SURPLUS (DEFIIT) TOTAL PERIOD EXPENSES SUB-TOTAL AMPAIGN EXPENSES EXLUDED FROM LIMITATION Recount Interest on Loans Expense in holding a Fund-Raising Function The Municipal ouncils and School Boards Elections Act ourt action commenced under Part 9, Accounting and Audit By-law No. 1/21 Form 4 - $ 1,6.7 $ 4,45.27 $ 1,1. $ $ $ $ $ 1,1. Statement of Income and Expenses -

5 AMPAIGN EXPENSES EXLUDED FROM LIMITATION Sub-total ampaign Expenses Subject to Limitation S Total Income (reported from previous page) $ 4 STATEMENT OF INOME AND EXPENSES (continued) AMPAIGN PERIOD SURPLUS (DEFIIT) F) $ (445 TOTAL PERIOD EXPENSES $ SUB-TOTAL AMPAIGN EXPENSES EXLUDED FROM LIMITATION $ 11 Recount $ Interest on Loans $ Expense in holding a Fund-Raising Function S The Municipal ouncils and School Boards Elections Act ourt action commenced under Part 9, 5 Accounting and Audit $ 11 By-law No. 1/21 Form 4 - Statement of Income and Expenses - O. 7 4 of 14

6 Returned Returned ONTRIBUTIONS PART I FOR USE BY OUNILLOR ANDIDATES ONLY (Section 8(2)(b)) SHEDULE I - FOR OUNILLOR ANDIDATES ONLY TOTAL TO BE PAID TO THE SENIOR ELETION OFFIIAL $ ash and/or Goods and Services in excess of limits $ From anonymous sources S ONTRIBUTIONS TO BE PAID TO THE SENIOR ELETION OFFIIAL Excess cash over $75 - Excess over $75 in the form of Goods and Services - to the ontributor $ to the ontributor $ ONTRIBUTIONS IN EXESS OF LIMITS TOTAL ONTRIBUTIONS S Total of single source contributions of $25 or less $ 18,156 From candidate $ 75 a single source of more than $25 (complete Part II) Total of contributions in the Form of Goods and Services from $ From a single source totalling more than $25 (complete Part Ill) S 22,56 i/ By-law No. 1/21 Form 4 - Schedule 1 ouncillor - 8 of 14

7 a. - F E c.5- F k F t 2 -ø o = cn (ft.) t), -4-4,) ) E m m - T1 ).) I ) m )) I,.. ) - ) (. ) r, -o ) > a a,... -.

8 List of ontributors from Single Source totalling more than $25 PART HI TOTAL $ -. 8ui ±o EoxQr oo GEyfl, OO.OO {)& Tcoc ] 4&rc\ Oc os\ Pr Name Address SHEDULE I - FOR OUNILLOR ANDIDATES ONLY (continued) By-law No. 1/21 Form 4 - Schedule 1 ouncillor - 1 of 14

9 o ) o ( w o ( cj( ( l), = rn m -a,, -) ) I I -) m o, Di r -) -n ) ) Er ) D -) -U Di I -4 > ED r ij ;. >

10 Date: (ATTAH A DIFFERENT SHEDULE FOR EAH EVENT HELD) FUND RAISING FUNTION { fr FUND RAISING EVENTS INOME STATEMENT SHEDULE 2 11 of 14 If admission charge per person is not consistent, please provide complete breakdown of all ticket sales. * TOTALGROSS REVENUE: $ Other Revenue (Please Specify): $ REVENUE FROM FUNTION (A X B) $ Number of Tickets sold $ B *Admission harge (per person) $ A Type of Function: Held at: By-law No. 1/21 Form 4 - Schedule 2 -

11 Address: Name of financial institution: BORROWtNGS, OVERDRAFT, ET. SHEDULE Schedule - Name Address GUARANTORS (attach supplementary list if space insufficient) Terms of repayment: Interest rate: Principal Amount of Loan: $ By-law No. 1/21 Form 4 - Guarantee Amount of 12 of 14

12 expenses amount Amount included in Disputed (ATTAH LIST IF MORE SPAE REQUIRED) STATEMENT OF DISPUTED LAJMS SHEDULE 4 1 of 14 TOTAL DISPUTED LAIMS $ $ TOTAL FROM SUPPLEMENTARY LIST ATTAHED $ $ Reason for Dispute Nature of Expense Name & Address of laimant $ $ Reason for Dispute Nature of Expense Name & Address of laimant $ $ Reason for Dispute Nature of Expense Name & Address of laimant $ $ By-law No. 1/21 Form 4 - Schedule 4 -

13 I By-law No. 1/21 Form 4 - Auditors Report - 14 of 14 AUDITOR S REPORT REFERENE: SETION 21(1) Name of andidate Official Agent Office Ward Name (if councillor candidate) Janice Lukes on-lee Paterson ouncillor St. Norbert / we have examined the statements of assets and liabilities and income and expenses of Janice Lukes Name of andidate candidate, for the campaign period ending 1//215 Date ampaign Period Ended relating to the election held on 22-Oct-14 Date of Election These statements, which have not been and were not intended to be, prepared in accordance with anadian generally accepted accounting principles, are solely for the information and use of the ampaign Expenses and ontributions Officer for the ity of Winnipeg for complying with By-law No. 1/21 of The ity of Winnipeg harter. The statements are not intended to be and should not be used by anyone other than the specified users or for any other purposes. These financial statements are the responsibility of the registered candidate and official agent. My/our responsibility is to express an opinion on these financial statements based on my/our audit. My/our examination was made in accordance with generally accepted auditing standards. Those standards require that I/we plan and perform an audit to obtain responsible assurance whether the financial statements are free of material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes such test and other procedures as I/we consider necessary in the circumstances except as explained in the following paragraph. Due to the nature of the types of transactions inherent in an election campaign, it is impracticable through auditing procedures to determine that the accounting records include all donations of goods and services, receipts and disbursements for the campaign period. Accordingly, my/our verification of these transactions was limited to ensuring that the financial statements reflect the amounts recorded in the accounting records of the candidate, in accordance with established accounting procedures and I/we was/were not able to determine whether any adjustments might be necessary to receipts and disbursements. In my/our opinion, except for the effect of adjustments, if any, which I/we might have determined to be necessary had I/we been able to satisfy myself/ourselves as to the completeness of the records as described in the preceding paragraph, these statements present fairly the information contained in the accounting records on which the statements are based in accordance with prescribed accounting treatment. oi Signature of Auditor