HomeMy WebLinkAboutJames Blair
The Corporation of the City of Pickering
Pickering Civic Complex
One The Esplanade
PICKERING Pickering, ON L1V 6K7
1811 BICENTENNIAL 2011 cityofpickering.com
Administration Department
Legal & Legislative Services Division - Clerk's Office
T. 905.420.4611
Toll Free 1.866.683.2760
TTY 905.420.1739
Fax 905.420.9685
Email clerks@cityofpickering.com
March 28, 2011
SENT VIA REGISTERED MAIL
I
James Blair
682 Foxwood Trail
Pickering, ON L1V 3X8
Subject: 2010 Municipal Elections - Financial Statement
- File: A-2000-001-11
TAKE NOTICE that you are in default of the requirements of the Municipal Elections
Act, 1996, as amended, because you failed to file documents, namely your financial
statement, with the City Clerk as required by Section 78 of the Municipal Elections Act,
1996, as amended, on or before 2:00 p.m. on Friday, March 25, 2011.
As a result, you are now ineligible to be elected or appointed to any office to which the
Municipal Elections Act, 1996, as amended, applies until the next regular election has
taken place in 2014.
If you have any question regarding this matter, please feel free to contact me directly at
905.420.4660 ext. 2019.
Yours truly
Debbie Shields
City Clerk
DS:kn
I
~r Ontario M'nistryofMunicipal Affairs Financial Statement -Auditor's Report
and Housing
Form 4
Municipal Elections Act, 1996 (Section 78)
Instructions
All candidates must complete Boxes A, B, C, D, E and F and Schedule 1. All candidates must complete Schedules 2, 3 and 4 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 DID
For the campaign period from (day candidate filed nomination) 1a010 0 3Q to L(
❑ 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 45`h day after voting day in a by-election)
Box A: Name of Candidate and Office
Name of Candidate
Last Name - First Name/ Middle In ~ jlL Am eS
Mailing Address
Suite/Unit No. Street No. Street Namox
Z_
City/To Provinc Postal Code
Telephone No. (incl. area code) Fax No. Em I Address
Business Home
~yos) yyz -ZZZ
Name of office for which the candidate sought elec ion Ward Name or N . (if any)
t 0 ~C c 0 1
Name of Munici y
! G /,/1/
Box B: Summary,of Campaign Inc a and Expenses
1. My spending limit as issued by clerk) was - - - - - - - - - - - - - - - - - - - - $ 3 g Z
2. Surplus (or deficit) from previous election - - - - - - - - - - - - - - - - - - - Fs
3. Total contributions received (from Schedule 1) - - - - - - - - - - - - - - - - - - - Is 7 Q 3
4. My total campaign expenses that were subject to the spending limit were (from Box C)
5. My total campaign expenses that were not subject to the spending limit were (from Box C) - - $
6. Total of all campaign expenses (from Box C) - - - - - - - - - - - - - - - - - - $ Z
7. Election campaign surplus/deficit from current election (from Box E) - - - - - - -
8. Contributions refunded to candidate or spouse (from Box E) - - - - - - - - - - - - $
9. Amount paid to clerk (from Box E) - - - - - - - - - - - - - - - - . - - - - - - - $
9503P (2010/01) @ Queen's Printer for Ontario, 2010 Disponible en franpis Page 1 of 8 .
Box C: Statement of Campaign Period Income and Expenses
From To For Candidate
0201° 0 °o~1~ i~°~
INCOME
Candidate's surplus from immediately preceding election released by the clerk + $
Contributions from candidate - - - - - - - - - - - - - - - - - - + $ ,
Contributions from spouse of candidate - - - - - - - - - - - - - - + $
All other contributions - - - - - - - - - - - - - - - - - - - - - + $
Revenue from fund-raising functions not deemed a contribution
(from Schedule 2, Part 111) - - - - - - - - - - - - - - - - - - - - - + $
Interest income - - - - - - - - - - - - - - - - - - - - - - + $
Other (provide full details) .
1. +
2. + $ X03
3. + $
Total Campaign Period Income - - - - - - - - - - - - - - - - - - - - - - - - C1
EXPENSES (Note: include the value of contributions of goods and services)
Expenses Subject to Spending Limit
Advertising - - - - - - - - - - - - - - - - - - - - - + $
Bank,charges - - - - - - - - - - - - - - - - - - - - - - + $ G
Brochures - - - - - - - - - - - - - - - - - - - - - - - +
Interest on loan - - - - - - - - - - - - - - - - - - - - - - + $
Inventory contributed to candidate's campaign (Schedule 3) - - - - - + $
Meetings hosted - - - - - - - - - - - - - - - - - - - - - + $
Nomination filing fee - - - - - - - - - - - - - - - - - - - + $ 00
Office expenses - - - - - - - - - - - - - - - - - - - - - - + $
Phone and/or Internet - - - - - - - - - - - - - - - - - - - + $ O
Salaries and benefits/honoraria/professional fees - - - - - - - - - + $
Signs - - - - - - - - - . - - - - - - - - - - - - - - - + $ O
Other (pro ' /full details)
2. + $
3. + $
Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - C2
Expenses Not Subject to Spending Limit
Accounting and audit - - - - - - - - - - - - - - - - - - - - + $
Costs of fund-raising function (from Schedule 2, Part Iv) - - - - - - - - + $
Expenses related to compliance audit - - - - - - - - - - - - - - + $
Expenses related to controverted elections - - - - - - - - - - - - + $
Expenses related to recounts - - - - - - - - - - - - - - - + $
Voting day party / appreciation notices - - - - - - - - - - - - - - + $
Expenses related to candidate's disability (provide details)
1. + $
2. + $
3. + $
Other (provide full details)
1. $
2. + $
3. + $
Subtotal - - - - - - - - - - - - - - - - - - - - - - - - - - _ $ C3
Total Campaign Period Expenses (C2) + (C3) - - - - - - - - - - - - - - - - - - - - - _ $ C4
Excess (Deficiency) of Income over Expenses (Cl) - (C4) - - - - - - - - - - - - - - - - _ $
Page 2 of 8
9503P (2010/01)
Box D: Statement of Assets and Liabilities as at 20
Assets
Cash - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Accounts receivable - - - - - - - - - - - - - - - - - - - - + $
Value of inventory retained (from Schedule 4) - - - - - - - - - - - - + $
Other (provide full details)
1. + $
2. + $
3. + $
Total Assets - - - - - - - - - - - - - . - - - - - - - - - - - - - - - - - - -
Liabilities and Excess (Deficiency) of Income over Expenses
Accounts payable - - - - - - - - - - - - - - - - - - - - - - + $
Borrowings, overdraft - - - - - - - - - - - - - - - - - - - - - + $
Other (provide full details) _
1. + $
2. + $
3. + $
Total Liabilities - - - - - - - - - - - - - - - - - ` - - - - - - - - - - - - - - - _ F7 ___1
Box E:`Statement of Determination. of Surplus,or Deficit and Disposition of Surplus
Part I - Determination of Surplus or Deficit
Amount of excess (deficiency) of income over expenses (from Box C) - - - - - - - - - - - + $ E1
Deduct: Any deficit carried forward by the candidate from immediately preceding election
if the offices are with respect to the same jurisdiction - - - - - - - - - - - - - - - - - $ E2
Surplus (or deficit) for the campaign period (E1) - (E2) - - - - - - - - - - - - - - - - - - - $
Deduct: Any refund of contributions to the candidate or spouse (only if there is a surplus) - - - - - - - $
Total Determination - - - - - - - - - - - - - - - - - - - - - - - - - - - - - E3
Part If - Disposition of Surplus
If line E3 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..
Surplus paid to the municipal clerk of the municipality of
Box F: Declaration
a candidate in the municipality of
R~ n o G g~ ;Uq hereby declare that to the best of my knowledge and belief that these
financial statements and att ched supporting schedules ague and correct.
Declared before (clerk or commissioner)
inthe 1 "cV_Ct`t v,
on (yyyy/mm/dd) Q_G L L G l E~ S
Signature of Clerk or Commissioner Signature of Candidate
r~
ao t t lC~ 3/ 2S :S5
Date Filed in the Clerk's Office (yyyy/mm/dd)
DEBBIE M. SHIELDS, CITY CLERK,
CITY OF PICKERING,
EX OFFICIO COMMISSIONER 25 MAR li 3:52fti
PURSUANT TO SECTION 1121
OF THE COMMISSIONERS FOR
TAKING AFFIDAVITS ACT.
9503P (2010/01) Page 3 of 8
I .
Schedule 1 - Contributions - f
Part I - Contribution
Contribution from candidate - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Contribution from spouse - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Total from each single contributor totalling more than $100
• include all ticket revenue where ticket price exceeds $100
• include all goods and services where value exceeds $100"
• do not include contributions from candidate or spouse - - - - - - - - - - - - - - + Is
Total from each single contributor totalling $100 or less
• include all ticket revenue where ticket price is $100 or less
• include all goods and services where value is $100 or less*
• do not include contributions from candidate or spouse - - - - - - - - - - - - +
*Note: Goods and services must also be reported as expenses in Box C
Less: Contribution returned or payable to the contributor - - - - - - - - - - - - - - - - - - $
Contribution paid or payable to the clerk - - - - - - - - - - - - - - - - - - - - - - $ 1A
Total Amount of Contribution - - - - - - - - - - - - - - - - - - - - - - - - - - _ $
Total contribution from anonymous sources - - - - - - - - - - - - - - - - - - - - $ 1 B
Amount of contributions paid or payable to the clerk (1A) + (1 B) - - - - - - - - - - - - - - -
Part II - List of Contributions from Each Single Contributor Totalling More than $100
Table 1: Monetary contributions from individuals other than candidate or spouse
Name Address Amount
❑ Additional information is listed on separate supplementary attachment Total $
9503P (2010/01) Page 4 of 8
Table 2: Monetary contributions from unions or corporations
Name (Legal and Carrying on Address President or. Cheque Signatory Amount
Business As) Business Manager
❑ Additional information is listed on separate supplementary attachment Total $
Table 3: Contributions in goods or services (Note: must also be'reported as expenses in Box C)
Name Address Goods or Services Amount
WC !vz 7 14-01
lrv~ C / rltl
$
$
$
$
$
$
Additional information is listed on. separate supplementary attachment Total $
Total Part II Contributions $
9503P (2010/01) Page 5 of 8
I
Schedule 2 - Fund-Raising Function _
❑ Additional schedule for each event or activity held is/are listed on separate supplementary attachment(s)
Date Description of event or activity
YYYY MM DD
Admission charge (per person)* (may not exceed individual contribution limit) - - - - - - - - - - $ 2A
*If admission charge per person is not consistent, attach complete breakdown of all ticket sales. _
Number of tickets sold - - - - - - - - - - - - - - - - - - - - - - - - - - ~ 2B
Part I - Ticket Revenue
Lines: (2A) x (2121) (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - - - -
Part II - Other Revenue Deemed A Contribution
Provide full details (e.g., revenue from goods sold in excess of fair market value)
1. - - - + $
2. - - - + $
3. - - - + $
4. - - - + $
5. - - + $
6. - + $
7. - - + $
8. - + $
Total Part II Revenue (include in Schedule 1) - - - - - - - - - - - - - - - - - - - - - -
Part III - Other Revenue Not Deemed A Contribution
Provide full details (e.g., contributions of $10 or less; revenue from refreshment sold at cost)
1. - - + $
2. - - - + $
3. - - - + $
4. - - - + $
5. - - - ± $
6. - - + $
7. - - - + $
8. - - - + $
Total Part III Revenue (include in Box C) - - - - - - - - - - - - - - - - - - - - - - - _ $
Part IV - Expenses Related to Fund-Raising Function.
Venue - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Event advertising - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Food and drink - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Entertainment - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - + $
Other (provide full details)
1. - - - + $
2. - - + $
3. - + $
4. - - + $
5. - - - + $
6. - - - + $
7. - - + $
8. - - + $
Total Part IV Expenses (include in Box C) - - - - - - - - - - - - - - - - - - - - - - -
9503P (2010/01) Page 6 of 8.
Schedule 3 7 Inventory.of Campaign Goods and Materials (from Previous Campaign)
Used in Candidate's Campaign
Description Date Acquired Supplier Unit Value Quantity Total Value
(yyyy/mm/dd)
Total Value of Inventory from Previous Campaign Used in Candidate's Campaign $
Schedule4 Inventory of Campaign Goods and Materials at The End of Campaign
Description Date Acquired Supplier Unit Value Quantity Total Value
(yyyy/mm/dd)
Total Value of Inventory of Campaign Goods and Materials $
9503P (2010/01) Page 7 of 8
L
Auditor's Report
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. 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
Professional Designation of Auditor
Municipality Date (yyyy/mm/dd)
Contact Person Licence No.
Last Name First Name
Address
Suite/Unit No. Street No. Street Name
City/Town Province Postal Code
Telephone No. (incl. area code) Fax No. Email Address .
ext.
9503P (2010/01) Page 8 of 8