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r� <br /> I �`'Ontario Ministry of Municipal Affairs Financial Statement — Auditor's Report <br /> and Housing <br /> Form 4 <br /> Municipal Elections Act, 1996(Section 78) <br /> Instructions: <br /> All candidates must complete Boxes A and B.Candidates who receive contributions or incur expenses beyond the nomination fee <br /> must complete Boxes C, D, Schedule 1,and Schedule 2 as appropriate.Candidates who receive contributions or incur expenses in <br /> excess of$10,000 must also attach an Auditor's Report. <br /> 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 <br /> for the conduct of the election. <br /> YYYY MM DD YYYY MM DD <br /> For the campaign period from (day candidate filed nomination) ,014 09 05 to 2014 12 31 <br /> ® Primary filing reflecting finances to December 31 (or 45`h day after voting day in a by-election) <br /> ❑ Supplementary filing including finances after December 31 (or 45`h day after voting day in a by-election) <br /> Box A: Name of Candidate and Office <br /> Candidate's name as shown on the ballot <br /> Last Name Given Name(s) <br /> Cacciavillani Elvira <br /> Name of office for which the candidate sought election Ward name or no. (if any) <br /> Councillor <br /> Name of Municipality <br /> Kingsville <br /> Spending limit issued by clerk <br /> $1-;__.5#517,, 7f6 . S a <br /> ❑ I did not accept any contributions or incur any expenses other than the nomination fee. (Complete Box A and B only) <br /> Box B: Declaration <br /> I, Elvira Cacciavillani a candidate in the municipality of <br /> Kingsville hereby declare that to the best of my knowledge and belief that these <br /> financial statements and attached supporting schedules are true and correct. <br /> Declared before(clerk or commissioner) <br /> in the —70—WA) dc �C i�✓GS�� C <br /> on (yyyy/mm/dd) 0/S- 0 3 /3 <br /> Signature of Clerk or Commissioner l Signature of Candidate <br /> 2015 e3 /3 <br /> Date Filed in the Clerk's Office(yyyy/mm/dd) <br /> 9503P(2013/11) 0 Queen's Printer for Ontario,2013 Disponible en franrais Page 1 of 8 <br />