HomeMy WebLinkAboutLisa McFarlandr�
�r"�Ontario
Ministry of Municipal Affairs Financial Statement — Auditor's Report
and Housing
Form 4
Municipal Elections Act, 1996 (Section 78)
Instructions:
All candidates must complete Boxes A and B. Candidates who receive contributions or incur expenses beyond the nomination fee
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 his or her spouse) shall be paid immediately over to the clerk who was responsible
for the conduct of the election.
YYYY MM DD YYYY MM DD
Forthe campaign period from (day candidate filed nomination) 2f}i5 12 0� to �'O16 0� 11
� Primary filing reflecting finances to December 31 (or 45'h day after voting day in a by-election)
❑ Supplementary filing including finances after December 31 (or 45t1i day after voting day in a by-election)
Box A: Name of Candidate and Office
Candidate's name as shown on the ballot
Last Name
�1cFarland
Given Name(s)
Lis�
Name of office for which the candidate sought election Ward name or no. (if any)
(;it_y C�o�i��cillc>r- i�a'ara I
Name of Municipality
Pickeri���;
Spending limit issued by clerk
�24,323.90
❑ I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and 8 only)
Box B: Declaration
I, I..,ds� iJJcF�d�la��d , a candidate in the municipality of
F'i�lc€;ran�? , hereby declare that to the best of my knowledge and belief that these
financial statements and attached supporting schedules are true and correct.
Declared before (clerk or commissioner)
in the C�ity c�f Piukering
on (YYYY/mm/dd) � � �� �' � ; �� ^� ' �e
;
Signature of Clerk or Commissioner
_ , �l� �� _ d -�
Date Filed in the Clerk's Office (yyyy/mm/dd)
__-_ - -
_,_
� �
'�,'_I�l , C� _ _ - _� A �`�s;'� _;.
f .�
�_,
Signature of Candidate
RISA DIANN� HARKEF�,
a Caanmissior�er, etc.,Regional Municipal'rty
of Durham, forTheCorporationofthe
Cityat Pickering.
Expires January 28, 2018
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Box C: Statement of Campaign Incorr9e and Expenses
LOAIV
Name of bank or recognized lending institution
Amount borrowed - - - - - - - - + $
INCOME
Total amount of all contributions (From line 1A in Schedule 1) +$ �,050.00
Refund of nomination filing fee +$ 100.Ov
Sign deposit refund + $
Revenue from fund-raising events not deemed a contribution (From Part III of
Schedule 2) + $
Interest earned by campaign bank account +$
Other (provide full details)
1. + $
2. + $
3. + $
Total Campaign Income (Do not include loan) _$ �,�jO.pQ C1
EXPENSES (Note: include the value of contributions of goods and services)
Expenses subject to spending limit
Nomination filing fee +$ 1 pp.�p
Inventory from previous campaign used in this campaign (list details in Table 5
of Schedule 1) + $
Advertising + $ 3,]51.7�
Brochures/flyers ¢ $ 3,>47.92
Signs (including sign deposit) + � ] , ( g�, � �
Meetings hosted + g
Office expenses incurred until voting day +$
Phone and/or Internet expenses incurred until voting day +$ S0.(�4)
Salaries, benefits, honoraria, professional fees incurred until voting day +$
Bank charges incurred until voting day +$ 5,�?
Interest charged on loan until voting day +$
Other (provide full details)
1. + $
2. + $
3. + $
'Total Expenses subject to spending limit = $ �$,($3$,(�Q C2
Expenses not subject to spending limit
Accounting and audit + $
Cost of fund-raising events/activities (list details in Part IV of Schedule 2) +$
Voting day party/appreciation notices + $
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 + g
Expenses related to recount + �
Expenses related to controverted election +$
Expenses related to compliance audit + g
Expenses related to candidate's disability (provide full details)
1. + $
2. + $
3. + $
Other (provide full details)
1. + $
2. + $
3. + $
Total Expenses not subject to spending limit
1'otal Campaign Expenses (C2 + C3)
_ $ 0.00 C3
_ $ $,03 $.00 C4
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:• )' �: s a a r �.
Excess (deficiency) of income over expenses (Income — Total Expenses)
(C1 — C4)
Eligible deficit carried fonrvard by the candidate from the last election
�otai (D7 - D2)
If there is a surplus, deduct any refund of candidate's or
spouse's contributions to the campaign
Surplus (or deficit) for the campaign
+ $ 112.00 D1
- $ ().00 D2
_ $ 112m00
- $ 113.00
_ $ t).0() D3
If line D3 shows a surplus, the amount must be paid in trust, at the time the financial statements are filed, to the municipal clerk who was
responsible for the conduct of the election.
Amount of $
paid to municipal clerk in the municipality of
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Schedule 1 - Contribcations
Part I— Summary oi Contributions
Contribution from candidate (indude the value of inventory listed in Table 5) +$ 6,�{}0.0(7
Contribution from spouse + $
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 $100 or less (do not
include contributions from candidate or spouse). +$
Tota! value of contributions exceeding $100 per contributor (from line 1 B; list
details in Tables 1— 4)
• Include ticket revenue, contributions in money, goods and services where
the total contribution from a contributor exceeds $100 (do not include
contributions from candidate or spouse). +$ 1,750.Q0
Less: Contributions returned or payable to the contributor —$ 0.00
Contributions paid or payable to the clerk, including contributions from
anonymous sources exceeding $10 — $
Toial Amount of Contributions (Record in Box C) _$ �,050.00 1A
Part II — List of Contributions from Each Single Contributor Totalling more than $100
l'able 1: Monetary contributions from individuals other ihan candidate or spouse
Name Full Address Amount $
.Tetlnifer McFarlat�d 1311 Haggis I)rive, }�eteebar€�ug]�, C.)ntari��, K9K 2�9 ?�(},{){}
❑ Additional information is listed on separate supplementary attachment Total I �SQ•��a
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iable 2: fVlonetary contributions from corporations or unions
Narne (Legal and Carrying on Full �,ddress Presiden� or
Business As Business IVlana e
I�'N Cc��asulti�g Inc. l 837 Post Drive, L,isa lE�cFarlar�d
I'ickerin�, Ontaric�, Li!/
4Y$
G��-don I�3. Mc�`arl�nd 598 �harlatte Street, f��ord McFarland
F'rc�%ssianal Cc�i°�Uration F'eterborot�gh, Ontario,
I��3J `H �
Authorizeci
Representative
I..,isa McFa��laa�d
Gord ivtcFarla��d
�
f�
7sa.c�o
❑ Additional information is listed on separate supplementary attachment Total 1,SQ0.�0
Table 3: Contributions in goods or se►vices from individuals other than candidaie or spouse
(Note: must also be recorded as ex enses in Box C
Name Full Address Description of Goods Value $
or Services
❑ Additional information is listed on separate supplementary attachment
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Total
Page 5 of 8
�
Table 4: Contributions in oods or services from cor orations or unions (Note: must also be recorded as expenses in Box
Name of Corporation Full ,4ddress President or Authorized Description of Value $
(Legal and Carrying on Business Manager Representafiive Goods or Services
Business Asl
0 Additional information is listed on separate supplementary attachment
'fotal Part II Contributions (Add Totals frorn Tables 1-4) (Record in Part I— Summary)
Part 111— Inventory
Table 5: Inventory of Campaign Goods and Materials from Previous Campaign used in this Campaign
(Note: value must be recorded as a contribution from the candidate and as an expense)
Description Date Acquired Supplier Current Market Quantity
(vvvv/mm/rlril ValUe $
❑ Additional information is listed on separate supplementary attachment
�ota� � n
$ 1,754.001 B
Total Value $
Total
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[t7
Schedule 2— Fundraising Events and Activities
Fundraising EventlActivity
Gomple4e a separate schedule for each event or aciiviiy heid
❑ Additional schedule(s) attached
Description of fundraising event/activity
Date of event/activity (yyyy/mm/dd)
Part I — Ticket Revenue
Admission charge (per person)
(If there are a range of ticket prices, attach complete breakdown of all ticket
sales) + g
Number of tickets sold X
Total Ticket Revenue (2A x 2B) (Include in 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 Pari !I Revenue (include in Schedule 1)
Part 119 — Other revenue not deemed a contribution
(provide details (e.g. contributions of $10 or less; market value of goods or services sold))
1. + $
2. + $
3. + $
4. + $
5. ,r $
Totai Part III Revenue (include in Box C)
Part IV — Expenses related to fundraising event or activity (provide details)
1. +
2. +
3. +
4. +
5. +
6. +
7. f
8. �
Total Part IV Expenses (include in Box C)
$
$
$
$
$
$
$
2A
2B
_ $
� g
_ �
_ $
9503P (2013/11) Page 7 of 8
�auditor's Repor�
Municipal Elections Act, 1996 (Section 78)
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
Contact Information
Name
Last Name
Address
Suite/Unit No. � Street No. ( Street Name
C itylTown
First Name
Province
Telephone No. (including area code) Fax Na Email Address
e�.
Date (yyyy/mm/dd)
Licence Number
Postal Code
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
� Report is attached
Personal information, if any, collected on this form is obtained under the authority of sections 78 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.
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