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2006 Financial Statements - City of Pickering

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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 S10 000 and expenses incurred<br />

by the candidate do not exceed SI0 000<br />

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

shalI<br />

be paid immediately over tothe clerk who was responsible for the conduct<strong>of</strong> the election This<br />

form may be electronicalIyfiled if your council has passed an enabling by-law For the<br />

campaign period from day candidate n minated<br />

hto<br />

rl1/<br />

A NAME OF CANDIDATEANDOFFICE Name<br />

ro 2107 BOX<br />

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

N L<br />

-G Mailing<br />

Address S<br />

Z-C- Business<br />

PhoneNo10<br />

Ward<br />

nameor numberif any M<br />

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

Oe- Name<br />

lctLeE-NC BOX<br />

B SUMMARY OF CAMPAIGN INCOME AND EXPENSESI<br />

My Spending Limit wast Zf51 70 2<br />

Surplus or Deficit from Previous Election<br />

3<br />

Total Contributions Received Box<br />

C and Box D -25<br />

ft CJv 4<br />

My<br />

Total Campaign Expenses that were Subject<br />

to the Spending Limit were- L<br />

5 My Total Campaign Expenses that were<br />

not Subject to the Spending Limitwere f<br />

0<br />

6 Total <strong>of</strong> All Campaign Expenses<br />

line 4 line 5<br />

-7 Election Campaign<br />

Surplus/Deficit<br />

Election<br />

from Current<br />

8 Portion <strong>of</strong> Campaign Surplus Returned to Candidate<br />

9503P<br />

his or her Spouse or Same-Sex PartnerG-<br />

2003/07 Pagelol3 Continued

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