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2006 Financial Statements - City of Pickering

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0<br />

FORM 4<br />

FINANCIAL STATEMENT<br />

MUNICIPAL ELECTIONS ACT 1996 SECTION 78<br />

INSTRUCTIONS<br />

To be filed if the contributions received by a candidate do not exceed<br />

by the candidate do not exceed 10 000<br />

10 000 and expenses incurred<br />

Any surplus greater than 500 after any refund to the candidate his or her spouse or same-sex partner shall<br />

be paid immediatelyover to the clerk who was responsible for the conduct<strong>of</strong> the election This<br />

form may be electronicallyfiled if your council<br />

has passed<br />

an enabling by-law For the<br />

campaign period from day candidate nominatedLi f to r c<br />

OF CANDIDA TE AND OFFICE cQoo Name<strong>of</strong><br />

Candidate<br />

8-/6lBOX<br />

A NAME<br />

C--1/<br />

f<br />

--S<br />

I<br />

L Address<br />

t Mailing<br />

-<br />

j to t<br />

/ /1<br />

- t p L / f C / u -<br />

l<br />

r<br />

l f PI 11 - p C k<br />

2Fi hJJ<br />

Business Phone<br />

No Fax No<br />

Dt-J1 E-mail Address<br />

I j<br />

-1 J<br />

i--t<br />

i-/-Home Phone No Name<strong>of</strong> Officefor<br />

which the Candidate Sought<br />

Election p<br />

GL C<br />

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

-3 Name<br />

Municipality<br />

w C<br />

r<br />

t -I r rI r-<br />

f<br />

tc<br />

t ro<br />

t<br />

0 1 j<br />

Zj<br />

-t l 7I L<br />

-<br />

Ward<br />

name or<br />

numberifanyI-I<br />

BOX B SUMMARY OF CAMPAIGN INCOME AND EXPENSES I<br />

Limit<br />

was<br />

g/Od -0 N/A<br />

2<br />

My<br />

Spending<br />

Surplus<br />

or Deficitfrom<br />

Previous Election 3 Total Contributions<br />

Received Box<br />

C<br />

and<br />

Box D 1/1L/ 4My<br />

Total Campaign Expenses that were Subject to the<br />

were<br />

1 1 L/D 5My<br />

Total Campaign Expenses that were not Subject<br />

to the Spending Limit were6<br />

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

All Campaign<br />

Spending<br />

Expenses line 4line 5 --7<br />

Election<br />

Campaign Surplus/Deficit from Current Election 8 Portion<strong>of</strong><br />

Campaign Surplus Returned to<br />

Candidate his orher<br />

Limit<br />

Spouse or Same-Sex Partner 9503P 2003/07 Page

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