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HomeMy WebLinkAboutCampaign Life Coalitionrte.. V Ontario Instructions: Ministry of Municipal Affairs Financial Statement - Auditor's Report Third Party - Form 8 Municipal Elections Act, 1996 (Section 88.29) All registrants must complete Boxes A, B, C and D and Schedule 1. All registrants must complete Schedule 2 as appropriate. Registrants 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 registrant or, if the registrant is an individual, their spouse) shall be paid immediately over to the clerk who was responsible for the conduct of the election. YYYY MM DD YYYY MM DD For the campaign period from 1 2 0 1 8 1 1 0 1 1 9 1 to 12 0 1 8 1 2 1 3 1 n initial filing reflecting finances to December 31 (or 45 days after voting day in a by-election) Supplementary filing including finances after December 31 (or 45 days after voting day in a by-election) Box A: Name of Registrant Name of Registrant (iiidividuair trade oi. or corporation) Campaign Life Coalition Official Representative (name of person signing on behalf of trade union or corporation) Given Name(s) Jeffs Lynn Last Name or Single Name Municipality Pickering Spending Limit — General $ `6Q 55.05 [Box B: Declaration 1, Lynn Jeffs Spending Limit — Parties and Other Expressions of Appreciation , a registrant (or official representative) declare that to the best of my knowledge and belief that these financial statements and attached supporting schedules are true and correct. Si fnature of nt (or Official Representative) March ai lq Date (yyyy/ m/dd) Date Filed (yyyy/mm/dd) 90riI03 I a l Time Filed 2: 53,pni Initial of Registrant, Official Representative or Agent (if filed in jrson) 10552P (2018/04) © Queen's Printer for Ontario, 2018 Disponible en frangais Signature of Clerk or Designate Page 1 of 8 Box C: Statement of Campaign Income and Expenses LOAN Name of bank or recognized lending institution Amount borrowed INCOME Total amount of all contributions (From line 1A in Schedule 1) Revenue from items $25 or less 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. 4. 5. Total Campaign Income (Do not include loan) EXPENSES (Note: include the value of contributions of goods and services) Expenses subject to general spending limit 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) 1. 2. 3. 4. 5. Total Expenses subject to general spending limit + $ + $ + $ + $ + $ $ C1 + $ + $ + $ + $ + $ _ $ C2 EXPENSES Expenses subject to spending limit for parties and other expressions of appreciation 1. + $ 2. 3. 4. 5. Total Expenses subject to spending limit for parties and other expressions of appreciation 10552P (2018/04) Page 2 of 8 Expenses not subject to spending limit 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 a registrant's disability (provide full details) 1. 2. 3. 4. 5. Other (provide full details) 1. 2. 3. 4. 5. Total Expenses not subject to spending limits Total Campaign Expenses (C2 + C3 + C4) C4 $ C5 Excess (deficiency) of income over expenses (Income minus Total Expenses) (C1 — C5) If there is a surplus, deduct any refund of registrant's or spouse's contributions to the campaign Surplus (or deficit) for the campaign + $ ZS2 D1 — $ _ $ D2 If line D2 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. 10552P (2018/04) Page 3 of 8 Schedule 1 — Contributions Part I — Summary of Contributions Contributions in money from registrant and (if individual) spouse + $ Contribution in goods and services from registrant and (if individual) 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 registrant or spouse). + $ + $ Total value of contributions exceeding $100 per contributor (from line 1 B; list on page 6; 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 registrant or spouse). + $ 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 totalling more than $100 — individuals other than registrant or spouse Table 1: Monetary contributions from individuals other than registrant or spouse Name Full Address Date Received Amount $ Received Amount $ Returned to Contributor or Paid to Clerk Additional information is listed on separate supplementary attachment Total 10552P (2018/04) Page 4 of 8 Table 2: Monetary contributions from corporations or trade unions Name (legal and carrying on business as) Full Address President or Business Manager Authorized Representative Date Received Amount $ Received Amount $ Returned to Contributor or Paid to Clerk Additional information is listed on separate supplementary attachment Total Additional information is listed on separate supplementary attachment Total Table 3: Contributions in goods or services from individuals other than registrant or spouse (Note: must also be recorded as expenses in Box C) Name Full Address Description of Goods or Services Date Received Value $ Amount $ Returned to Contributor or Paid to Clerk Additional information is listed on separate supplementary attachment Total 10552P (2018/04) Page 5 of 8 Table 4: Contributions in goods or services from corporations or trade unions (Note: must also be recorded as expenses in Box C) Name (legal and carrying on business as) Full Address President or Business Manager Authorized Representative Description of Goods or Services Date Received Value $ Amount $ Returned to Contributor or Paid to Clerk n Additional information is listed on separate supplementary attachment Total Total Part II Contributions (Add Totals from Tables 1-4) (Record in Part I — Summary of Contributions) Part III — Contributions from registrant or spouse Table 1: Contributions in goods or services 1B Description of Goods or Services Date Received (yyyy/mm/dd) Value $ n Additional information is listed on separate supplementary attachm ent Total 10552P (2018/04) Page 6 of 8 Schedule 2 - Fundraising Events and Activities Fundraising Event/Activity Complete a separate schedule for each event or activity held L 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 Part I (2A X 2B) (include in Part 1 of Schedule 1) Part 11— Other revenue deemed a contribution (e.g. revenue from goods sold in excess of fair market value) Provide details 1. 2. 3. 4. 5. 2A 2B $ Total Part II (include in Part 1 of Schedule 1) = $ Part III — Other revenue not deemed a contribution (e.g. contributions of $25 or less; market value of goods or services sold) Provide details 1. 2. 3. 4. 5. Total Part III (include under Income 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 (include under Expenses in Box C) = $ 10552P (2018/04) Page 7 of 8 Auditor's Repork Municipal Elections Act, 1996 A registrant who has received contributions or incurred expenses in excess of $10,000 must attach an auditor's report. Professional Designation of Auditor Municipality 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 Postal Code 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 provide an opinion as to the completeness and accuracy of the financial statement and whether it is free of material misstatement El Report is attached Personal information, if any, collected on this form is obtained under the authority of sections 88.29 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. 10552P (2018/04) Page 8 of 8