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CAMPAIGN FINANCE STATEMENT - Michael Thompson - 20221024y Ministry of Municipal Affairs eta ri0 and Housing 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 who receive contributions or incur expenses must complete Boxes C, D, Schedule 1 and Schedule 2 as appropriate. Candidates who receive contributions or incur expenses 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 immediately paid to the clerk who is responsible for the conduct of the election. YYYY MM DD YYYY MM DD For the campaign period from (day clerk received nomination 7] GG�.Z + UL� � 0 to -� Initial filing reflecting finances from start of campaign to December 31 (or 45 days after voting day in a by-election) [] Supplementary filing reflecting finances from start of campaign to end of extended campaign period Box A: Name of Candidate and Office Candidate's name as shown on the ballot Last Name or Single Name Given N f Office for Which the Candidate Sought Election Municipality litflf`1f Spending Limit General 2�Z Ward Name or Number (if any) Contribution Limit Parties and Other Expressions of Appreciation Contributions from Candidate and Spouse -7. L $ I did not accept any contributions or incur any expenses. (Complete Boxes A and B only) Box B: Declaration L"1 declare that to the best of my knowledge and belief that these financial statements and�ttJshed supporting schedules are true and correct. Signature of Candidate 2,q2i3 Da�O(yyyy/ Idd) Date Filed (yyyylmmldd) Time Filed Initial of Candidate or Agent (if filed in person) Signature of )tA. iuy, (-VIA oyDe5�ignate 9503P (2022104) © Queen's Printer for Ontario, 2022 Disponible en frangais Page 1 of 7 Box C: Statement of Campaign Income and Expenses LOAN Amount borrowed Name of bank or recognized lending institution $ INCOME Total amount of all contributions (from line 1A in Schedule 1) + $ 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. $ 1, �� C1 Total: Campaign Income (Do not include loan) EXPENSES (Note: Include the value of contributions of goods and services) 1. Expenses subject to general spending limit ai n used in this campaign Inventory from previous camp g (list details in Table 2 of Schedule 1) + $ of Advertising + $ Qt. Brochures/flyers Signs (including sign deposit) + $ Meetings hosted 7 + $ �S Office 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)�� � I + $ tom! + 4 r,- V,y, 1 + $ 2. J + $ z 4� 4. + $ 5. 6. D C2 Total Expenses subject to general spending limit $ SJ s 2. Expenses subject to spending limit for parties and other expressions of appreciation 1 Page 2 of 7 9503P(2022104) 2. + $ 3. + $ 4. + $ 5. + $ Total Expenses subject to spending limit for parties and other expressions of appreciation = $ C3 3. 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 incurred after voting day + $ Salaries, benefits, honoraria, professional fees incurred after voting day + $ Bank charges incurred after voting day + Interest 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 full details) 1. + $ 2. + $ 3. + $ 4. + $ 5. + $ Other (provide full details) 2. + $ 3. + $ 4. + $ 5. + $ Total Expenses not subject to spending limits = $ C4 Total Campaign Expenses (C2 + C3 + C4) _ $ �z. f C5 Box D: Calculation of Surplus or Deficit Excess (deficiency) of income over expenses (Income minus Total Expenses) (Cl — C5) + $ Z�, 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 = $ + 02 If line D2 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, who is responsible for the conduct of the election. to the municipal clerk 9503P (2022/04) 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) 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 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: Ineligible contributions paid or payable to the contributor Contributions paid or payable to the clerk, including contributions from anonymous sources exceeding $25 Total Amount of Contributions (record under Income in Box C) Part II — Contributions from candidate or spouse e. ^....4--- in n .Ae nr SPry ICP-% 1A Description of Goods or Services Date Received (yyyy/mm/dd) Value ($) Total Additional information is listed on separate supplementary attachment, if completed manually. Table 2: Inventory of campaign goods and materials from previous municipal campaign used in this campaign t b recorded as a contribution from the candidate and as an expense.) (Note. Value mus e Description Date Acquired (yyyy/mmldd) Supplier Quantity Current Market Value ($) Total Additional information is listed on separate supplementary attachment, if completed manually. Part III — Contributions exceeding $100 per contributor — individuals other than candidate or spouse Page 4 of 7 9603P(2022/04) Table 3: Monetary contributions from individuals other than candidate or spouse Name Full Address Date Received Amount Amount Returned (yyyy/mm/dd) Received ($) to Contributor or Sor of (-'(?C�Es6--, - ZL' J Paid to Clerk ($) Gam'. p U U fit L �. �} fa�� �c�[ rf2Rr7r 647AC, t . a � i Y1 L3Q _ t L ut {) L S E O IJ A(i Lk-)_ ) r ry 2Z622 z zczz_09 z6 ZKS M , jVrcr4 o n u3w & �,� �4r) tag 2,?Vo 6e 55,&-Jo 14-, 8 7oz`t a, Q.. / dc�0 V'j Sv Flt �vr�:rS b�I r7v ^ r# yt,. o 14 -,A Zoaz ro I (] Z y /C-er7'q a 51; Total _©,Additional information is listed on separate supplementary attachment, if completed manually. Table 4: Contributions in goods or services from individuals other than candidate or spouse (Note: Must also be recorded as Expenses in Box C.) Name Full Address Description of Goods Date Received Value ($] or Services (yyyy/mm/dd) Total Additional information is listed on separate supplementary attachment, if completed manually. Total for Part III — Contributions exceeding $100 per contributor (Add totals from Table 3 and Table 4 and record the total in Part 1 — Summary of Contributions) $ is 9503P (2022/04) Page 5 of 7 Schedule 2 — Fundraising Events and Activities Complete a separate schedule for each event or activity held. I Q Additional schedule(s) attached, if completed manually. Fundraising EventlActivity 1 Description of fundraising event/activity Date 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 26 Total Part I (2A X 2B) (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 III — 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 III (include under Income in Box C) Pan`. 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) M, 9503P(2022/04) Page 6 of 7 Table 3: Monetary contributions from individuals other than candidate or spouse Name Full Address Date Received (yyyylmmld d) ZU 2z fc 15 d,��, Cyr z4zzIto�d'? Amount Amount Returned Received ($) to Contributor or Paid to Clerk ($) 76c) z LOv Total �- 0 0 Additional 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.) Name Full Address Description of Goods Date Received Value ($) or Services (yyyylmmldd) Total [] Additional information is listed on separate supplementary attachment, if completed manually. Total for Part III — Contributions exceeding $100 per contributor (Add totals from Table 3 and Table 4 and record the total in Part 1 — Summary of Contributions) $ g 9503P (2022104) Page 5 of 7