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CAMPAIGN FINANCE STATEMENT - Melanie Wright - 20221024Ministry of Municipal Affairs Ontario& Financial Statement -Auditor's Report Candidate -Form 4 Municipal Elections Act, 1996 (Section 88.25) Instructions All candidates must complete Boxes A and B. Candidates w ho receive contributions or incur expenses must compl ete Boxes C, D, Schedule 1 and Schedule 2 as approp riate. Candi dates who receive contributions or incur expenses in excess of $10,000 must also attach an Auditor's Report. All surp lus funds (after any refund to the candidate or their spouse) shall be paid Immediately o ver to the clerk w ho is responsible for t he cond uct of the election. yyyy MM DD MM DD For the campaign period from (day candidate filed nomination) I d69°' I o 1 I \ <5 I to I \o 131 ~ Initial filing reflecting finan ces to December 31 (or 45 days after voting day in a by-electio n) 0 Supplementary filing including finances after December 31 (or 45 days after voting day in a by-e lection) Box A : Name of Candidate and Office Candidate's name as shown on the ballot Last Name or Single Name ~x· V\-\- Office for which 't candidate soug ht election V\Ab\\c 5c,V)ool 0cc,\( d -rx:-us +ee Municipality (0 U\ Spending Limit -General $ Given Name(s) ffi~ \CH'\\ e,; Ward name or no. (if any ) Spending Limit -Parties and Other Express ions of A pprec iation $ D I did not accept any contributions or inc ur any expenses. {Complete Bo xes A and B only) Box B: Declaration I, (Y\-e\ c (\, e We l5b::t . decl a re that to the best of my knowledge and belief that these fina ncial statements a n d attached supporting schedules are true and correct. gn ! re of Candidate JO~ \~ 6 \ 1\/\f\ . Date (yyy /mm /d d ) Date Fil ed (yyyy/mm/dd) Time Filed Initial of Candidate or Agen t (if filed in person ) Ju.)3/ G · I .:ll 9503P (2018104) © Queen·s Printer for Ontario. 2018 Disponible en frarn,ais Page 1 of 8 --- -------- -------- -------- _____ -- -------- -------- Box C: Statement of Campaign Income and Expenses LOAN Name of bank or recognized lending insti tution ---=-----------------------------Amount borrowed $ -e- INCOME Total amount of all contributions (from line 1A in Schedule 1) + $ 360 -oO 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. + $ -'-------- Total Campaign Income (Do not include loan) = $ C1 EXPENSES (Note : include the value of contributions of goods and services) Expenses subject to general spending limit Inventory from previous campaign used in this campaign (list details in Table 4 of + $ / Schedule 1) Advertising + $ / Brochures/flyers + $ -- Signs (including s ign deposit) Meetings hosted Office expenses incurred until voting day + $ ./""' Phone and/or internet expenses incurred until voting day + $ 7 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. ___________________________ +_$ ______ ....,.- 2 . + $ ------,.&;.-- 3. + $ 4. + $ 5. + $ --..:..----~- Tot a I Expenses subject to general spending limit = $ ___;;'----C2 EXPENSES Expenses subject to spending limit for parties and other expressions of appreciation 1 . + $ 2. +-$~~~~---.--;-?: --/3 . + $ -----------------------------------,!.'----~ +$ ,,__ _ ___ / ___ 5 . + $ / Total Expenses subject to spending limit for parties and other expressions of appreciation = $ C3 Page 2 of 8 9503P (201810 4) ---------------------------- ---------------------------- ---------------------------- ---------------------------- Expenses not subject to spending limits Accounting and audit + $ / Cost of fundraising events/activities (list details in Part IV of Schedule 2) + $ / Office expenses incurred after voting day + $ ../' Phone and/or internet expenses inc urred after votin g day + $ ~ Salaries, be nefits, hon oraria, professional fees incurred after voting day + $ ~ Bank charges incurred after voting day + $ / Interest charged on loan after voting day + $ 7 < Expenses re lated to re co unt + $ / . Expenses related to controverted election + $ / Expenses related to compliance audit + $ / Expenses related t o candidate's disability (provide full details) + $ 1. ---------------------------' 2 . + $ / 3 . + $ / 4 . + $ / + $ / 5. ---------------------------- Other (provide full details) + $ 1. ----------------------------~ 2. + $ / + $ / 3 . ---------------------------- 4. + $ / ----------------------------7 + $ 5. ----------------------------T ot a I Expenses not subject to spending limits = $ C4 Total Campaign Expenses (C2 + C3 + C4) = $ / C5 Box D: Calculation of Surplus or Deficit Excess (deficiency) of in come over expenses (Income mi nu s Total Expenses ) (C1 -C5 ) + $ D 1 Eligibl e deficit carried forward by the can d id ate from the last election (applies to 2018 reg ula r election only) -$ D2 Total (D1 -D2) = $ If there is a surplus, deduct any refund of ca nd idate's or spouse's co ntributio ns to th e ca mpaign -$ S urplus (or deficit) for th e campaign = $ D3 If line D3 shows a surplu s, the amount mu st be paid in trust, at the t ime the financial st atements are fi led, to the municipal clerk who is responsib le for the conduct of the election . 9503P (2018/04) Page 3 of 8 -------- Schedule 1 -Contributions Part I -Summary of Contributions Contributions in money from candidate and spouse + $ J?t7, 00 Contributions in goods and services from candidate and spouse (include value listed In Table 3 and Table 4) + $ {g\ b , 05' Total value of contributions not exceeding $100 per contributor Include ticket 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 Bon page 5; list details in Table 1 and Table 2) 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). + $ 300 . 00 $ -e-Less: Contributions returned or payable to the contributor Contributions paid or payable to the clerk, including contributions from anonymous sources exceeding $25 - $ Total Amount of Contributions (record under Income in Box C) = $ 1A Part II -Contributions exceeding $100 per contributor -individuals other than candidate or spouse Table 1: Monetary contributions from individuals other than candidate or spouse Name Full Address Date Received Amount Received $ D-ebo,a h \{i mffo0 · 2s ~C\~e" \-\ \\ \ 6hrc\. ~+. 7,, "Stb \A -ffv \ \ \.e I Ov'\-\"-$300.00 L L\-A-0 L-5<' 20)d- 0 Additional information is listed on separate supplementary attachment Total 3C>O ·on 9503P (2018104) Amount$ Returned to Contributor or Paid to Clerk Page 4 of a Table 2: Contributions in goods or services from individuals other than candidate or spouse (Note: must also be recorded as Expenses in Box C) Name Full Address Description of Goods or Services Date Received (yyyy/mm /dd) Value$ D Additional information is listed on separate supplementary attachment Total -e- Total for Part II -Contributions exceed ing $100 per contributor (Add totals from Table 1 and Table 2 and record the total in Part 1 • Summary of Contributions) Part Ill -Contributions from candidate or spouse Table 3: Contributions in goods or services Description of Goods or Services Date Received (yyyy/mm/d d ) Value$ 'i or d / E= \-echof' Su3V\S ~.\-.Jo. g.o ;;)-;} (_olb .cg5 D Additional information is listed on separate su pplementary attachment T otal (o\6 ·155 9503P (2018/04) Page 5 of 8 Table 4: 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 Supplier Quantity Current Market (yyyy/mm/dd) Value$ D Additional Information Is listed on separate supplementary attachment Total -Pr Page eora 9503P (2018/04) • Schedule 2 -Fundraislng Events and Activities Fundraising Event/Activity Complete a separate schedule for each event or activity held D Additional schedule(s) attached Description of fund raising event/acti vity Date of event/activ ity (yyyy/mm/dd) Part I -Ticket revenue Admission charge (per pe rson) (If there are a range of ticket prices , attach comp lete breakdown of all ti cket sales) Number of tickets sold Total Part I (2A X 2B) (include in Part 1 of Schedule 1) X $ 2A 2B = $ -er- Part II -Other revenue deemed a contribution (e.g . re venue from goods sold in excess of fair market value) Provide details 1. + $ 2. + $ 3 . + $ 4. + $ 5. + $ Total Part II (include in Part 1 of Schedule 1) = $ -fr Part Ill -Other revenue not deemed a contribution (e .g. contribution of $25 or less; goods o r services sold for $25 or less) Provide details 1. + $ 2. + $ 3. + $ 4 . + $ 5. + $ Total Part Ill (include under Income in Box C) = $ Part IV -Expenses related to fundraising event or activity Prov ide details 1. + $ 2. + $ 3. + $ 4 . + $ 5 . + $ 6. + $ 7 . + $ 8 . + $ Total Part IV Expenses (incl ude under Expenses in Box C) = $ -er 95 03P (2018/04) Page 7 of 8 0 • ~A'tittit~r~~r:·rte~l);rf :;,{,~->r:·;~~;_:/:' ,. . ' :: ,~L~:_:·~~:'.'?!: ;:.~'.-.-. ,.~ ·.c,-.-~-'.'.~. :· -~ ~,'" . -~· .. 1.::_:i •. • .. •. --.:._ ··.·.-.•_·.·.r.·.·.' _· .. i._,: .. -.;_i,.:j_'.-;-······.·., .• ~_T_ •. ~.~.: .• _: ..• ;.-.: ..• =.-..•. ·_:.·.:'.~.~.·.~·.: .. ·.·c·}·-"·;=-·:~.-.--.·.· .. ·.-.;~-;:-: .,:r.~.i'..f., :.-~,.;·;."_ •. ··.i····.·._·.· .. .•• .... _:.; .• _},~.-.~.-.r, •. ~.•-·.·.: .• _ ... "'!M"".Ji"'"IJ"'t"°{&"'i"".l"p"':1'"'~[""']2i""1s""~"t,"';_a"'}""l1""·-~'"'P"'~-"'ls""'i2~,"'t\~"'(rz:l~"'".~"'•··~"',!"',l"'f""tt"'i;"',r.======'· -"··cc· =======-"· '2'•'··""···.·2;:""')"":;;"":_."'"-""''====~: 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 No. Street No. Street Name Municipality Province Telephone No. (Including area code) Email Address The report must be done In accordance with generally accepted auditing standards and must: set out the scope of the examination Postal Code provide an opinion as to the completeness and accuracy of the financial statement and whether it ls free of material misstatement 0 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 Munlolpal Elections Act, 1996 are public records and, unill their destruction, may be inspected by any person ai 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. Page8of8 9503P (2018104)