Loading...
CAMPAIGN FINANCE STATEMENT - Asim Sayed - 20221024Ministry of Municipal Affairs Financial Statement -Ontario& and Housing Auditor's Report Candidate -Form 4 Municipal El ecti ons Act, 1996 (Section 88 .25) Instructions All cand idates must co mplete Boxes A and B. Cand idates who re c eive contributi o ns o r incu r expens e s must comp lete Bo xes C , D , Schedule 1 and Schedule 2 as appro priate. Candidates who receive co nt ribu ti ons o r incu r exp en ses in excess of $10 ,000 must also attach an Auditor's Report . All surplus funds (after any refund to the candidate or their spouse) shall be immediatel y pai d t o t he clerk w ho is res po ns ib le for the conduct of the election. YYYY MM D D YYYY MM D D For the campaign period from (day clerk received nomination) 2..C.2.2.. 0~ I 03 to .__I ___ __ __ ~'+J I I _2S:0 2..2. __.__IO _,_l____,I ~ Initial filing reflecting finances from start of campaign to December 31 (or 45 days aft er voti ng day in a b y-elec t ion ) D Supplementary filing reflecting finances from start of c ampa ign to end of extended ca mp aign per iod Box A: Name of Candidate and Office Candidate's name as shown on the ballot Last Name or Single Name SA,eb Given Name(s ) A~,m Offic e fo r Which the Candidate Sought Election Ward Name or Numbe r (if an y) la '-(l<t6f?> trvslec.-1-\/~1 h:hl,n:h ~{{le-~~ Municipality \ .. ,: n , ol2K Kt>~-e-r--- Spending Limit Contrib ution Limit Parties and Other Expressions of Appreciati on Cont ributi ons fro m Candidate and Spou s e $ $ ~ , 003 ,"il D I did not accept any contributi o ns o r in c ur any e xpenses. (Complete Boxes A a nd B o nly) Box B: Declaration I, , decla re that to t he best of my k now ledge and belief that these financial statements and attached supporting schedules are true and cor rect. ~ andidate Date (yyyy/mm/dd ) Date Filed (yyyy/mm/dd ) T ime Filed Initial of Candidate or Agent (if filed in perso n) Jo o :os ~ A-. g , 9503P (2022/04) © Queen's Printer for Ontario, 2022 Disponib le en fran~ais Page 1 of 7 ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ Box C: Statement of Campaign Income and Expenses LOAN Name of bank or recognized lending institution Amount borrowed Ncn-~ I ccJo'lv $ ~ -~~ INCOME Total amount of all contributions (from line 1A in Schedule 1) + $ l-1~ . ye, Revenue from items $25 or less + $ ~ -~ Sign deposit refund + $ ~-~ Revenue from fundraising events not deemed a contribution (from Part Ill of Schedule 2) + $ ~ -~ Interest earned by campaign bank account + $ ~ -~ Other (provide full details) 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ 6. + $ Total Campaign Income (Do not include loan) = $ l-1~. YB C1 EXPENSES (Note: Include the val ue of contributions of goods and services) 1. Expenses subject to general spending limit Inventory from previo us campaign used in th is campaign (list detai ls in Table 2 of Schedule 1) Advertising Brochures/flyers Signs (includ ing sign deposit) Meetings hosted Offic e expenses incurred until voting day Phone and/or internet expenses incurred until voting day Salaries , benefits , honoraria, professional fees incurred until voting day Bank charges incurred until voting day Interest charged on loan until voting day Other (provide full details) 1. + $ ~ + $ 8~ .5~ + $ '=131 , .:Y8 + $ ~ + $ © + $ ~ + $ ~ + $ ~ + $ ~ + $ ~ + $ 2. + $ 3. + $ 4. + $ 5. + $ 6. + $ Total Expenses subject to general spending limit = $ =J/2°48 C2 2 . Expenses subject to spending limit for parties and other expressions of appreciation 1. +$~ 9503P (2022/04) Page 2 of7 ------------------------- 2. + $ 3. + $ 4. + $ 5. + $ Tota l Expenses su bj ect to spend ing lim it for part ies and other expressions of appreciation 3. Expenses not s ubject to spending limits Accounting and audit Cost of fund raising events/activities (list details in Part IV of Schedule 2) Office expenses incurred after voting day P hone and/or internet expenses incurred after voting day Salaries , benefits, honoraria, professional fees incurred after voting day Bank charges incurred after voting day I nte rest charged on loan after voting day Expenses related to recount Expenses related to controverted election Expenses related to compliance audit Expenses related to candidate 's disability (provide fu ll details) 1. = $ ~ C3 + $ + $ + $ + $ + $ + $ + $ + $ + $ + $ + $ 2. + $ 3. + $ 4. + $ 5. + $ Other (provide fu ll details) 1. + $ 2. + $ 3. + $ 4. + $ 5 . + $ Total Expenses not subject to spend i ng lim its = $ ~ C4 Total Campaign Expenses (C2 + C3 + C4) = $ =J-12. L./8 C5 Box D: Calculation of Surplus or Deficit E xcess (deficiency) of income over expenses (Income minus Total Expenses) (C1 -C5) + $ D1 If there is a surplus, deduct any refund of candidate's or spouse's contributions to the campaign -$ Surplus (or deficit) for the campaign = $ D2 If line D2 shows a surp lus , the amount must be paid in trust , at the time the financia l statements are f iled , to the mun icipal cle rk who is responsib le for th e conduct of the election. 9503P (2022104) Page 3 of 7 Schedule 1 -Contributions Part I -Summary of Contributions Contributions in money from candidate and spouse Contributions in goods and services from candidate and spouse (include value listed in Table 1 and Table 2) T ot al value of contributions not exceeding $100 per contribu tor • Include t icket 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 1 B; list details in Table 3 and Table 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). Less: I nelig ible contributions paid or payable to the contributor Contributions paid or payable to the clerk , including contribut ions from anonymous sources exceeding $25 Total Amount of Contributions (record under Income in Box C) Part II -Contributions from candidate or spouse Table 1: Contributions in goods or services + $ b3 · yea + $ ~ + $ ~ /o L/9 . ~~ + $ ~ -$ ~ .~~ -$ ~ . $tQ = $ 1A 3J2. 4 8 Description of Goods or Services Date Received (yyyy/mm/dd) Value($) Total D Additiona l information is listed on separate supplementary attachment, if completed manuall y. Table 2: Inventory of campaign goods and materials from previous municipal campaign used in this campaign (Note: Value must be recorded as a contribution from the candidate and as an expense.) Description Date Acquired (yyyy/mm/dd) Supplier Quantity Current Market ·Value ($) Total D Add itiona l information is listed on separate supplementary attachment, if completed m anua lly. Part Ill -Contributions exceeding $100 per contributor-individuals other than candidate or spouse 950 3P (2 022/04) Page 4 of 7 Table 3: Monetary contributions from individuals other than candidate or spouse Name Full Address Date Received (yyyy/mm/dd) Amount Received ($) Amount Returned to Contri butor or Paid to Clerk ($) AdnC\tA. kh~iri.., 23Y8 hJ,1,,\r-,1..{t ~ Ve Ln m5CD \X -:'./$&)3Y 2022/ to/ 2.1 $~15~ ~o ~kmrni A~'::1ol 52-qqdic...k eJ~ Not H,,i '1CiYK i /'l!3H GC 2-4>2-L/ 9 / 2,b $Y99 ~o Total $~ b'i-~ ~ -<S)~ D Additiona l information is listed on separate supplementary attachment, if completed manually. Table 4: Contributions in goods or services from individuals other than candidate or spouse (Note: Must also be recorded as Expenses in Box C.) (}-19· DO Name Full Address Description of Goods Date Received or Services (yyyy/mm/dd) D Additional information is listed on separate supp lementary attachment, if completed manually. Total for Part Ill -Contribut ions exceeding $100 per contributor Total Value($) ~~. ~~ (Add totals from Table 3 and Table 4 and record the total i n Part 1 -Summary of Contributions) $ ~ 18 9503P (2022/04) Page 5 of 7 ----------------------------- ------------------------ ------------------------ ------------------------ ------------------------ ------- ------------------------ ------------------------ ------------------------ ------------------------ ------------------------ Schedule 2 -Fund raising Events and Activities Complete a separate schedule for each event or activity held. D Additional schedule(s) attached, if completed manually. Fundraising Event/Activity 1 Description of fund raising event/activity D a I e of event/activity (yyyy/mm/dd) Part I -Ticket revenue Admission charge (per person) $ 2A -'------- (If there are a range of ticket prices, attach complete breakdown of all ticket sales) Number of tickets sold X 28 Total Part I (2A X 28) (include in Part I of Schedule 1) =$ Part II -Other revenue deemed a contribution Provide details (e.g., revenue from goods sold in excess of fair market value) 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ Total Part II (include in Part I of Schedule 1) =$ Part 111-Other revenue not deemed a contribution Provide details (e.g., contribution of $25 or less; goods or services sold for $25 or less) 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ Total Part Ill (include under Income in Box C) =$ Part IV -Expenses related to fundraising event or activity Provide details 1. + $ 2. + $ 3. + $ 4. ------------------------+ $ 5. + $ Total Part IV Expenses (include under Expenses in Box C) =$ 9503P {2022/04) Page6of7 Auditor's Report-Municipal Elections Act, 1996 (Section 88.25) 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 I Date (yyyy/mm/dd) Contact Information Last Name or Single Name Given Name(s) Licence Number Address Suite/Unit Number Street Number Street Name Municipality Province Postal Code Telephone Number Email 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 material misstatement D Report is attached Personal information, if any, collected on this form is obtained under the authority of sections 88.25 and 95 of the Municipal Elections Act, 1996. Under section 88 of the Municipal Elections Act, 1996 (and despite anything in the Municipal Freedom of Information and Protection of Privacy Act) documents and materials filed with or prepared by the clerk or any other election 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 clerk in an electronic format free of charge upon request. 9503P (2022/04) Page 7 of7