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Auditor's Report - City of Pickering

Auditor's Report - City of Pickering

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Ontario Ministry <strong>of</strong> Municipal Affairs<br />

and Housing<br />

Notice <strong>of</strong> Extension <strong>of</strong> Campaign<br />

Period Form 6<br />

Municipal Elections Act 1996 Sections 68 821<br />

Instructions<br />

To be completed and filed with the clerk by candidates or registrants requesting an extension <strong>of</strong> the campaign period<br />

due to a deficit<br />

This notice must be filed on or before December 31 in the year <strong>of</strong> a regular election and 45 days after voting day in the<br />

case <strong>of</strong> aby election<br />

Name <strong>of</strong> Candidate and Office Registrant and Question<br />

Name <strong>of</strong> Registrant Candidate<br />

Last Name First Nam Middle Ini al<br />

Mailing Address<br />

Suite Unit No Street Stre ame 1n<br />

<strong>City</strong> Town<br />

1j<br />

Telephone<br />

o incl area code Fax No Email Address<br />

Business<br />

Hom<br />

Province P9stal Co e<br />

6Ili<br />

Name <strong>of</strong> <strong>of</strong>fice for which the candidates ught election or the Ward<br />

question for which the registrant incurred expenses<br />

C C6 Gu<br />

Name <strong>of</strong> Mu<br />

cipality<br />

name or no if any<br />

Declaration fis the candidate registrant mentioned above hereby give notice<br />

and decl a tot clerk that I have a deficit and wish the campaign period to be extended in accordance with section 68<br />

Declared before me<br />

at the<br />

C rt<br />

<strong>of</strong><br />

Q C 1<br />

in the <strong>of</strong> V fna rY<br />

this day <strong>of</strong> Qom eavl r 20 1 Q<br />

Signature <strong>of</strong> Clerk ignature o a<br />

aoIri a I l<br />

Dateyyy mm dd de 16<br />

yyyr mm dd<br />

egistrant<br />

10550P 2010<br />

Queen s Printer for Ontario 2010<br />

Disponible en frangais

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