HomeMy WebLinkAboutKeith Falconer`r�j •
T/'l— r Ministry of Municipal Affairs F jnanClBl Stat@fil@ilt - Auditor's epOt't
✓ � 1 I and Housing
FOrm 4
Municipal E/ections 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.
YYW MM DD YYYY MM DD
For the campaign period from (day candidate filed nomination) 2 0 1 4 0 6 2 6( to 2 0 1 4 1 2 3 1
❑✓ Primary filing reflecting finances to December 31 (or 45th day after voting day in a by-election)
❑ Supplementary filing including finances after December 31 (or 45`" day after voting day in a by-election)
Bax A: "Nar�ne of �aiad�dat+� anc� C�ff�ce
Candidate's name as shown on the ballot
Last Name
Falconer
Given Name(s)
Keith
Name of office for which the candidate sought election Ward name or no. (if any)
Regional Councillor 2
Name of Municipality
Pickering
Spending limit issued by clerk
� 19,461.90
� I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and 8 only)
Bax B: Qecla�ra►�kon '
�, KEITH FALCONER
, a candidate in the municipality of
PICKERING , 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)
inthe �' i�-,.. p-� �" t C�C��'. v`.c
on (yyyy/mm/dd) a.,�j l 5� G 3 /�lo
V-
Signature of Clerk or Commissioner
a.015/o3fa.�
Date Filed in the Clerk's Office (yyyy/mm/dd)
� 1 ��� -
�; � r ,
� � i��� �R�
i � ,,1
� '� . � . � .� ': �,
♦. . ♦ A A;_ j,
Signatur of Candidate
9503P (2013/11) OO Queen's Printer for Ontario, 2013 Disponible en fran�ais Page 1 of 8
Box C: Sta�ement of Cam�ai�r� lncort�e anidf �x�enses
LOAN
Name of bank or recognized lending institution
Amount borrowed $
INCOME
Total amount of all contributions (From line 1A in Schedule 1)
Refund of nomination filing fee
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)
EXPENSES (Note: include the value of contributions of goods and services)
Expenses subject to spending limit
Nomination filing fee
Inventory from previous campaign used in this campaign (list details in Table 5
of Schedule 1)
Advertising
Brochures/flyers
Signs (including sign deposit)
Meetings hosted
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)
�. Mailing Costs
2. Volunteer Meals & Travel
3.
Total Expenses subject to spending limit
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
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.
Other (provide full details)
2.
3.
Total Expenses not subject to spending limit
Total Campaign Expenses (C2 + C3)
9503P (2013l11)
+ � 14,937.29
+ $ 100.00
+ $
+ $
+ $
+ $
+ $
+ $
_ � 15,037.29 c�
+ � 100.00
+ $
+ $ 3,817.17
+ $ 2,983.20
+ � 3,259.79
+ $
+ � 266.70
+ � 198.10
+ $
+ $ 3.21
+ $
+ � 1,168.85
+ � 553.40
+ �
_ � 12,350.42 c2
+ � 1,130.00
+ $
+ � 448.53
+ $
+ $
+ $
+ � 4.45
+ $
+ $
+ $
+ $
+ $
+ $
+ $
+ $
+ $
+ $
_ � 1,582.98 c3
_ � 13,933.40 ca
Page 2 of 8
Excess (deficiency) of income over expenses (Income — Total Expenses)
(C1 — C4)
Eligible deficit carried forward by the candidate from the last election
Total (D1 — 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
+ � 1,103.89 D1
— � D2
_ � 1,103.89
- � 1,103.89
_ � '� 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
9503P (2013/11) Page 3 of 8
Schedule 1 - Contributions
Part I— Summary of Contributions
Contribution from candidate (include the value of inventory listed in Table 5)
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).
Total 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).
Less: Contributions returned or payable to the contributor
Contributions paid or payable to the clerk, including contributions from
anonymous sources exceeding $10
Total Amount of Contributions (Record in Box C)
+ � 10,000.00
+ $
+ � 37.29
+ � 4,900.00
— $
— $
_ � 14,937.29 1A
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
Barry Browning
Full Address
2230 Walkers Line, Unit 15, Burlington, Ontario, L7M
3Y8
� Additional information is listed on separate supplementary attachment
Total
Amount $
350.00
350.00
9503P (2013/11) Page 4 of 8
Table 2: Monetary contributions from corp
Name (Legal and Carrying on Full Address
Business As)
see attached list
or unions
President or I Authorized
Business Manager Representative
� Additional information is listed on separate supplementary attachment
Table 3: 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
� Additional information is listed on separate supplementary attachment
Total
Description of Goods
or Services
Total
Amount $
Value $
4,550.00
9503P (2013/11) Page 5 of 8
Table 4: Contributions in goods or services from corporations or unions (Note: must also be recorded as expenses in Box C)
Name of Corporation Full Address President or Authorized Description of Value $
(Legal and Carrying on Business Manager Representative Goods or Services
Business As)
� Additional information is listed on separate supplementary attachment Total I
Total Part II Contributions (Add Totals from Tables 1-4) (Record in Part I— Summary) $ 4,900.00 � g
Part III — 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 Total Value $
(yyyy/mm/dd) Value $
[] Additional information is listed on separate supplementary attachment Total
9503P (2013/11) Pa e 6 of 8
9
Schedule 2— Fundraising Events and Activities
Fundraising Event/Activity
Complete a separate schedule for each event or activity held
� 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) + $
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 Part II Revenue (include in Schedule 1)
+ $
+ $
+ $
+ $
+ $
Part III — 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. + $
Total 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.
8.
Total Part IV Expenses (include in Box C)
+ $
+ $
+ $
+ $
+ $
+ $
+ $
+ $
2A
2B
_ $
_ $
_ $
_ $
9503P (2013l11) Page 7 of 8
A candidate who has received contributions or incurred expenses in excess of $10,000 must attach an auditor's report.
Professional Designation of Auditor
CPA, CA, LPA
Municipality
PICKERING
Contact Information
Last Name
EVANS
Address
Suite/Unit No. Street No.
LTNIT 6 1730
City/Town
PICKERING
First Name
MICHAEL
Street Name
MCPHERSON COURT
Telephone No. (including area code) Fax No.
905 420-9637 ext. 905 420-0910
Province
ON
Email Address
michael@gtaaccountant.com
The report must be done in accordance with generally accepted auditing standards and must:
Date (yyyy/mm/dd)
2015/03/OS
Licence N
1-16240
Postal Code
L1W 3E6
• 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.
9503P (2013/11) Page 8 of 8
Business Name Address Authorized Amount $
Representative
Dorsay Development 150 York St., Suite Toronto, ON Geoffrey Grayhurst 750.00
Corporation 1701 M5H 3S5
Toronto, ON
Triple Properties 186 Bartley Dr. M4A 1E1 Steve Apostolopoulos 750.00
Averton Developments 161 Pennsylvania Ave. Vaughan, ON Vincent Baffa 500.00
Suite 5 L4K 1C3
150 Ferrand Dr. Suite Toronto, ON
SR&R Development Group Ltd. 801 M3C 3E5 Steven Warsh 500.00
2402 Stouffville Rd., Gormley, ON
The Bench Press Ltd. p.0. Box 245 LOH 1G0 David Gray 250.00
Pickering, ON
Port Restaurant Inc. 1289 Wharf Street L1W 1A2 Ralph Morgan 750.00
1815 Ironstone Pickering, ON
Tribute Lands Inc. Manor, Unit 1 L1W 3W9 Lucy Stocco 750.00
Oshawa, ON
Durham Region Labour Council 115 Albert St. L1H 4R3 �im Freeman 100.00
Toronto, ON
The Biglieri Group Ltd. 20 Leslie St., Suite 121 M4M 3L4 Anthony Biglieri 200.00
fOTAL 4,550.00
Michael Evans, Chartered Accountant
1730 McPherson Court, Unit 6, Pickering, Ontario, Ll W 3E6
T: 905-420-9637 E: michael@gtaaccountant.com
INDEPENDENT AUDITOR'S REPORT
T0: Mr. Keith Falconer
Municipal Elections Act, 1996 (Section 78)
I have audited the Statements of Campaign Period Income and Expenses and Calculation of Surplus or Deficit, of
Keith Falconer, Candidate, for the campaign period of June 26, 2014 to December 31, 2014 for the Pickering
Municipal Election held on October 27, 2014. These financial statements are the responsibility of Keith Falconer,
Candidate. My responsibility is to express an opinion on these financial statements based upon my audit.
Except as explained in the following paragraph, I conducted my audit in accordance with Canadian generally
accepted auditing standards. Those standards require that I plan and perform an audit to obtain reasonable
assurance that the financial statements are free of material misstatement. An audit includes examining on a test
basis, evidence supporting the amounts and disclosures in the financial statement. An audit also includes
assessing the accounting principles used and significant estimates made by the Candidate as well as evaluating the
overall presentation of the financial statements.
Due to the inherent nature of the transactions inherent in an election campaign, it is impractical through auditing
procedures to determine that the accounting records include all donations of goods and services and receipts and
disbursements. Accordingly my verification of these amounts was limited to ensuring that the financial statements
reflect the amounts recorded in the Candidate's accounting records in accordance with the accounting procedures
established by the Municipal Elections Act, 1996 and I was unable to determine whether any adjustments might be
necessary to income and expenses, assets and liabilities, and surplus (deficit).
in my opinion, except for the effect of any adjustments, if any, which I might have determined to be necessary had
I been able to satisfy myself as to the completeness of the records as described in the preceding paragraph, these
financial statements present fairly in all material respects the income and expenses for the campaign period from
June 26, 2014 to December 31, 2014 and the determination of surplus (deficit) and the disposition of surplus in
accordance with the accounting treatment prescribed by the Municipal Elections Act, 1996.
The Municipal Elections Act, 1996 does not require me to report, nor was it practical for me to determine, that
contributions reported include only those which may be properly retained in accordance with the provisions of the
Municipal Elections Act, 1996.
MICHAEL EVANS, CHARTERED ACCOUNTANT
�c1�a�'- �`-
Pickering, Ontario, March 5, 2015