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r 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) 2 0 1 4 1 0 8 1 1 4 1 to 12 0 1 4 1 1 0 1 2 7 <br /> 0 Primary filing reflecting finances to December 31 (or 451h day after voting day in a by-election) <br /> ❑Supplementary filing including finances after December 31 (or 45`n 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 /> Ron Patrick <br /> Name of office for which the candidate sought election Ward name or no. (if any) <br /> councilor <br /> Name of Municipality <br /> Kingsville <br /> Spending limit issued by clerk <br /> $ 13 4Y7,7S-e,g5 <br /> F,/] 1 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, Ron Patrick 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 4f le-4&"s 1,114-LC, CyziLt t 6F e S5,eX. <br /> on(yyyy/mm/dd) ,2 J_2 p ' <br /> Signature of Clerk or Commissioner PC-r"7"l e LtP Si ndi <br /> re of ada e <br /> -/i 0,--714 5!54 6-6-6 <br /> Date Filed Anthe Clerk's Office(yyyy/mm/dd) <br /> 9503P(2013/11) ©Queen's Printer for Ontario,2013 Disponible en frangais Page 1 of 10 <br />
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