disclosure statements city of nanaimo. a :jo h. -c:s. e.€¦ · local government act section...
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Local Government Act Section 90
CITY OF NANAIMO
CAMPAIGN FINANCING DISCLOSURE STATEMENT FOR THE 2011 GENERAL ELECTION
(COUNCILLOR)
Form 3-9b
This disclosure statement is to be filed with the Manager of Legislative Services of the City of Nanaimo within 120 days after the local general election voting day (March 19, 2012). Disclosure statements may be filed from March 2dh, 2012 until April 18th, 2012 on payment of a $500 late filing penalty to the City of Nanaimo.
NAME OF CANDIDATE: ... ] \ a_ t'""\ C0 :J""o h. "- C:S. tQ f"\ E.
NAME OF OFFICE for which the candidate sought election: ----~C~O--"U'-'-N~C""""l=L=LO~R ____ _
NAME OF ENDORSING ELECTOR ORGANIZATION (if applicable):
SUMMARY OF CAMPAIGN CONTRIBUTIONS
Total amount of campaign contributions Total of (A, B & CJ from Schedule A: Part 1 (page 4)
List of contributors who made contributions totalling $100 or more Complete Schedule A: Part 2 (page 5)
Total amount of anonymous campaign contributions remitted to the City of Nanaimo
Total from Schedule A: Part 3 (page 6)
SUMMARY OF ELECTION EXPENSES
Total amount of election expenses
COMPLETE SCHEDULE B (page 7)
SURPLUS FUNDS
Transfer from local government (surplus funds from previous election)
Balance (positive or negative) remaining in candidate's campaign account
COMPLETE SCHEDULE C (page 8)
CAMPAIGN ACCOUNT INFORMATION
$ ____ _
$ ____ _
$ I OS • .2 .. y-
All m?netary contributions were ?eposite~ in, and all election expenses~ from an ~ccount opened for this purpose at 605-k,,,( Vo:x'> ""- '·fY''-11:'J G ed\t located at~!Af:\ nx::.c h )__3;f8
(name of financial institution) UI\ 1 O"- (Branch ad<;Jress)La..b \e_ tJ~ "
NOTE: This is not a balance sheet. For example, contributions may not equ'al expenses. COMPLETE THE APPROPRIATE DECLARATIONS ON PAGES 2 AND 3
Form 3-9b DECLARATION OF CANDIDATE
I, r-:]) lct..,~ a__, ~h_ f\. S. '=:C V'\. e , a candidate for COUNCILLOR in the City of Nanaimo election, solemnly affirm that to the best of my knowledge, information and belief:
(a) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo; and
(b) the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to my election campaign for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo.
Declared before me at _N ...... ~~c1x\~ ..... <1 ....... t .... r:Y) .............. 0......_ __ , British Columbia
this ?.. "'°' day of S>ei::..~
Designa dL alGovernmentOfficer or Commissioner for taking affidavits for British Columbia
, 201....L.
Signature of Candidate
DECLARATION OF ELECTOR ORGANIZATION OFFICIAL (if applicable)
I, _________________ , being the----------------(title of authorized official)
for the------------------------' solemnly affirm that to the (name of elector organization)
best of my knowledge, information and belief:
(a) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act for the election campaign of ________________________ _
(name of candidate)
for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo; and
(b) the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to the election campaign of ___________________ _ for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo.
Declared before me at , British Columbia ---------this ___ day of _________ , 201_.
Designated Local Government Officer or Commissioner for taking affidavits for British Columbia
Signature of Elector Organization Official
Page 2 of 13
Form 3-9b
DECLARATION OF CAMPAIGN ORGANIZER (it applicable)
I, ________________ , being the ______________ _ (title of authorized official)
for the------------------------' solemnly affirm that to the (name of elector organization)
best of my knowledge, information and belief:
(a) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act for the election campaign of ________________________ _
(name of candidate)
for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo; and
(b) the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to the election campaign of-------------------for the office of COUNCILLOR in the 2011 local general election for the City of Nanaimo.
Declared before me at _________ , British Columbia
this ___ day of _________ , 201 .
Designated Local Government Officer or Commissioner for taking affidavits for British Columbia
Signature of Campaign Organizer
DECLARATION OF FINANCIAL AGENT
I, --1--1--"----"-"°'-"""-',,;,,._,_----"-=.1..-4.....,._-<.!... _______ ----:_,,,,..."<"-___ ~ ::...._--, have prepared this
disclosure statement and supporting schedules for ------'=--....:....<..~'-'---:_/- 6_ 1-/,'-'-W--"-':-,,:::.....c__,__o_M....:...._'E ____ _ name of candidate (or elector organization or campaign organizer, if applicable)
and solemnly affirm that to the best of my knowledge, information and belief that:
(a) this campaign financing disclosure statement and supporting schedules completely and accurately discloses the information required by Section 90 of the Local Government Act in relation to the election campaign of---------------------
(name of candidate)
for COUNCILLOR in the 2011 local general election for the City of Nanaimo; and
(b) the requirements of Division 8 - Campaign Financing of the Local Government Act have been met in relation to the election campaign of ___________________ _
(name of candidate)
for COUNCILLOR in the 2011 local general election for the City of Nanaimo.
Declared before me at t-0~C"f'\C)
this ;;..~ day of ~'!:~
Design tedlo~overn~ent Officer or Commissioner for taking affidavits for British Columbia
, British Columbia
, 201L.
Page 3 of 13
CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS
SCHEDULE 'A'
PART 1: CONTRIBUTIONS
Contributions from known sources
Form 3-9b
Total value of contributions of $100 or more from a single source Unless nil, complete Schedule A: Part 2 (page 5).
(A} $ !JQ6<9
Total value of contributions totalling $99.99 or less from a single source (B} $ ,2._q7- ere,
Contributions from anonymous sources
Contributions from anonymous sources
LESS: value of anonymous contributions over $50 remitted to the City of Nanaimo
$ ___ _
(Total from Schedule A: Part 3-page 6) $ ___ _
Total value of anonymous campaign contributions of $50 or less = (C} $ --------
TOTAL VALUE OF CONTRIBUTIONS (A+ B + C) =
Total number of contributors who made contributions totalling $99.99 or less
Page 4 of 13
*1*
*2*
*3*
CAMPAIGN FINANCING DISCLOSURE STATEMENT CAMPAIGN CONTRIBUTIONS
SCHEDULE 'A'
PART 2: LIST OF CONTRIBUTORS TOTALLING $100 OR MORE from Item (A) (page 4)
*1* FULL NAME *2* ADDRESS DATE AMOUNT
C/CJ
"1 I 0-,:::.,
I ii
1D I, i ?'(J
' ( '1 /1, O(J
.2ro cc
Form 3-9b
*3*cLASS
2
~
l
o<_
\
Attach supplementary list if required
If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members.
Do not report addresses of individuals.
Classes: individual, corporation, unincorporated organization, trade union, non-profit organization, other.
Page 5 of 13
Local Government Act Section 90(4)(f) BC. Reg. 380/93
CAMPAIGN FINANCING DISCLOSURE STATEMENT
SCHEDULE 'B'
ELECTION EXPENSE DETAILS
A. Election campaign advertising or communication expenses for:
(1) radio, television, newspaper, magazine or electronic advertising for the public
(2) signs, pamphlets, flyers and brochures
(3) advertising and promotion for the public not included in A(1) or (2) above
(4) newsletters for members of the elector organization
B. Election campaign office expenses for:
Form 3-9b
$ l G S 'j 3/
$ 2 S<i'J... ~ $ ___ _
$ ___ _
(1) compensation paid to persons for campaign work, other than for $ ___ _
c.
D.
E.
F.
services described in Section 89(2) of the Local Government Act
(2) rent, insurance and utilities $ ___ _
(3) courier services and postage $ ___ _
(4) furniture, telecommunication equipment and other equipment $ ___ _
(5) office supplies and other office expenses not covered by 8(1) to (4) above $ ___ _
Convention and similar meeting expenses
Expenses for campaign related functions not described in C above
Research and polling expenses
Campaign related transportation
$ ___ _
$ ~
$ ___ _
$ ___ _
G. Other expenses (provide description)
$ ____ _
$ __ _
$ ____ _
$ ____ _
Total amount of other expenses $ ___ _
TOTAL AMOUNT OF ELECTION EXPENSES $ l}2 if! 7 /:;
D<:>nc:. 7 nf 1 "l
Local Government Act Section 90(4)
A.
B.
C.
CAMPAIGN FINANCING DISCLOSURE STATEMENT
SCHEDULE 'C'
DETAILS OF SURPLUS FUNDS DISBURSEMENT
Balance remaining in account
Amount reimbursed to candidate from campaign account for the candidate's contributions to his/her campaign
Amount of remaining surplus funds (after any reimbursement under B.)
D. Details of the disbursement of remaining surplus funds under C.
sh 4T'.f> S o.t- :±:0 b,a,;, )~ Q__' ~ \C::
1:-b"r ell¥ ;q I\ ocgan I z..o,--s
Form 3-9b
$====
Page 8 of .'.1 -S
CAMPAIGN FINANCING RECORD KEEPING FORM
RECORD OF CASH CAMPAIGN CONTRIBUTIONS
*1* FULL NAME *2* ADDRESS DATE AMOUNT (if aoolicable)
(_,~ uc.~< f) ~ tl cL. \I sO i • ~ Uc.·:~uxc.!S*e NoJ - \'- / 11 l (JC) cV
D.. 1Je i\-l/JI'. J,.f~ 4-UI.
1)cu,e qCL..-f- j~1~1 ~"(\:/t,..11(;,k Nov -w / 11 ~/.e/
lOCI , /
' _{,{j G retl r vJe,;_t- l)e,J\ p 3~q Lo.,c-i ,-e I S'f' j\hJ i b 111 N""'\ /H"\ ·1 , i' .:::t2...,.. \' -,r- · 1-., iJt::;.t:. ·1 M1 ,20() ....,
I
1-Lfce; vV
TOTAL
Form 3-9b
*3* CLASS
*1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors or principal officers or members.
*2* Do not report addresses of individuals.
*3* Classes: individual , corporation, unincorporated organization, trade union, non-profit organization, other.
Page 9 of 13
CAMPAIGN FINANCING RECORD KEEPING FORM
RECORD OF IN-KIND CAMPAIGN CONTRIBUTIONS I
*1*NAME *2*ADDRESS DATE GOOD or (if applicable) SERVICE
/_u\:::c Cct"-1 lt ;2..,q n- ic\ea)C,. ~ - ~u 1/1, _,., Seif\~ ::>
(d ,-ecJ G1"\S -\o.. ;,e (:,3$"0 GroJe \a.;\(_~ tU~ I\Jo 't) \ I ( , \.... v ,"r>- la e,,,i-
..Q;,- S"\q!"-1
C1rec1 Cons \-able · G ~ C, rwe\ <ir~J \\io J I . \\ 1,..., u _)/1
g ,q •'\ <~
e,-ce~4-
~u er-{ e-1 -=f:vl'\ l"I or ?l:3J ku'- tz~.1 /e \?d -N o u ;; 1 ----1c:l. ~" c\c.u. 'l Web ~;k--
f
!TOTAL I I I I
Form 3-9b
VALUE
Lf1..5 . 0-V
:).Co -'-o
\Oo · (JC.I
oc, \ '::-0
<i??S-~ I *1* If numbered corporation or unincorporated organization, include full name of 2 individuals who are directors
or principal officers or members.
*2* Do not report addresses of individuals.
Page 10 of 13
TOTAL
CAMPAIGN FINANCING RECORD KEEPING FORM
RECORD OF DISCOUNTED GOODS AND SERVICES
Form 3-9b
GOOD OR SERVICE PRICE PAID FAIR MARKET VALUE (RETAIL VALUE)
Page 11 of 13
CAMPAIGN FINANCING RECORD KEEPING FORM CAMPAIGN CONTRIBUTIONS
RECORD OF ANONYMOUS CAMPAIGN CONTRIBUTIONS $50 OR LESS
Form 3-9b
CONTRIBUTION VALUE/AMOUNT DATE REMITTED TO LOCAL (MONEY, GOODS) (if greater than $50) GOVERNMENT
TOTAL
Page 12 of 13
CAMPAIGN FINANCING RECORD KEEPING FORM
RECORD OF ELECTION EXPENSES
GOODS, PROPERTY OR SERVICES DATE DATE RECEIVED INCURRED PAID
TOTAL
Form 3-9b
AMOUNT
Page 13 of 13