1. law, govt and politics
2. politics
3. elections

_________
SAMPLE ONLY
te ELECTIONS
‘,
Financial Return for Candidate
Summary of Financial Activity
“% NOVA SCOTIA
Form 2-3
Elections Act Section 229 and 230(1)(b)
(Please print)
Candidate Name
Charles Smith
Electoral District
Halifax Area
Date
15-Dec-13
Party Affiliation (if any)
SectIon 1: Income & Transfers In
xxx Party
Non-cash
Cash
Monetary
2,300.00
4:
-
Fundraising Revenue
Form 5-i
Contributions in Kind & Discounts
I
ransters rrom “arty
Form 2-3A
&
Iiecwrai
uistrict ssociauons
510.68
Form 2-38
—
20,000.00
Form 2-SC
5,000.00
Form 2-3D
-
Proceeds from Loan or Line of Credit
Other Income (specify)*
10,025.68
Total Income & Transfers
Section 2: Expenses & Transfers Out
37,325,68
I
Non-election Expenses
6,891.68
Fundraising Expenses
Form 5-1
Election Expenses
Transfers to Party & Electoral District Associations
Payments on Loan or Loan of Credit
Interest Benefit on Loan or Line of Credit
9,634.00
Form 2-3F
3,000.00
Form 2-3C
5,000.00
Form 2-3D
10.68
Form 2-3D
Other Expenses (specify)
Total Expenses & Transfers
24,525.68
Net Excess (or Shortfall)
12,800.00
Auditor’s Report Attached (circle one)
No
Declaration
I declare, to the
true and correct
best of my knowledge and belief, that the information contained
and is in compliance with the Elections Act.
Signed at
Signature of Official Agent
include anticipated amounts to be received from Elections Nova Scotia
Form 2-3E
in this Form is complete,
,Nova Scotia on
15 —CC
—
——
ELECTIONS
Last Name
Doe
Smith
Jones
Smith
Doe
First Name
John
Mary
Tom
Steve
Mary
Halifax Area
Electoral District
Date
10-Sep-13
30-Sep-13
8-Oct-13
26-Sep-13
15-Sep-13
Charles Smith
Candidate Name
(Please pnnf)
w,“%NOVA SCOTIA
N5 Civic Address
123 Main Street
456 Main Street
256 Any Street
85 Oak Street
12 Oak Street
Elections Act Section 230(1)(c) & (e)
-
Halifax
Halifax
Halifax
Halifax
Halifax
—
—
—
—
—
Postal Code
B3J 3C8
B3i 3C8
B3J 308
83J 4X2
B3J 4X5
xxx Party
15-Dec-13
Subtotal
Total contribu ions less than $200 not listed above
Total: enter on Form 2-3
Party Affiliation (if any)
Date
Financial Return for Candidate
Statement of Monetary Contributions & Fundraising Events
SAMPLE ONLY
200.00
250.00
500.00
500.00
350.00
1,800.00
500.00
2,300.00
Ama
Form 2-3A
Henry
Interest Benefit
6-Oct-13
Jones
Henry
10-Aug-13
First Name
Description
Last Name
Office Space for Aug 10 to Sept
6
Smith
Halifax Area
Electoral District
Date
Charles Smith
NOVA SCOTIA
Candidate Name
(Please pnnt)
“%
)r ELECTIONS
Total: enter on Form 2-3
510.68
10.68
Halifax
B3J 4X8
222 Main Street
500.00
B3J 3C8
Halifax
856 Any Street
Amount
Postal Code
xxx Party
Party Affihiat n (if any)
Community
15-Dec-13
Date
Form 2-3B
NS Civic Address
EIectins At 5ertion 240 & 248
Financial Return for Candidat
Statement of Donations in Ku d
SAMPLE ONLY
SAMPLE ONLY
)
“
ELECTIONS
Financial Return for Candidate
Form 2-3C
Statement of Transfers to & from
Registered Party & Electoral District Association
NOVA SCOTIA
Elections Act SectIon 213, 214 & 230(1)(d)
(Please pnnt)
Candidate Name
Charles Smith
Electoral District
Halifax Area
:‘
10-Aug-13
l$a,e of Entity Transf
Date
15-Dec-13
Party Affiliation (if any)
xxx Party
..‘‘
xxx Electoral District Association
20,000.00
Total: enter on Form 2-3
Date
7-Oct-13
Name of Entity Transferred to
20,000.00
Amount’.-r 2
xxx Electoral District Association
3,000.00
lotal:
enter on
Form 2-3
3,000.00
_________________________________________________________________________________
SAMPLE ONLY
)
)((ii
ELECTIONS
Financial Return
Candidate
Loan
Credit
NOVA SCOTIA
Form 2-3D
for
or
line
of
EIectIon At senlon 218(3), 218(4) & 230(11(3)
(Please pñnt)
Candidate Name
Charles Smith
Electoral District
Halifax Area
15-Dec-13
Date
xxx Party
Party Affiliation (if any)
Name & Address of Lender
Henry Jones
125 Main Street, Halifax, NS B3J 3X2
Name(s) & Adress(es) of Guarantor(s) & Amount of Guarantee(s)
Nature of Transaction
Date
Proceeds
10-Sep-13
Loan to Charles Smith campaign
6-Oct-13
Payment to Charles Smith campaign
Net
Payments
5,000.00
5,000.00
5,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
:
0.00
Total: enter on Form 2-3
Date
Description of Calculation
Henry Jones interest from
Sept 10 to Oct 6 (26 days)
Original
Amount of
Loan
Loan Balance
Outstanding
Loan Interest
Rate
Bank Prime
Interest Rate
5,000.00
Bank Prime
Interest Rate
(a)
5,000.00
Interest at
Loan Interest
Rate (b)
0.00
Interest
Benefit (a-b)
-
10-Sep-13
5,000.00
0.00
0.00%
3.00%
10.68
0.00
10.68
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Total: enter on Form 2-3
10.68
-
-
(note can extend up 107 days after
Salary Paid
Salary Paid
06-Oct Candidate
06-Oct Official Agent
05-Oct Smith, Jill
11-Sep ENS
15-Oct KPMG
23
24
25
26
Enter totals on Form 2-3
Audit fee
Nomination fee
Salary Replacement
30-Sep Basebell NS
Reimbursement for expenses
Registation fee for baseball
tournament
21
05-Oct Offlical Agent
20
Food & alcohol for meet & greet
Signs from previous election
Lunch during canvassing
New shoes
Bank fees
Interest benefit (record on form 23B only)
22
28-Sep Jones, Tom
19
2009 Signs are Us
04-Oct Volunteers
17
18
06-Oct Jones, Henry
08-Oct CIBC
14
30-Sep Candidate
07-Oct Candidate
13
16
Candidate breakfast
07-Oct Comfort Inn
12
15
Candidate cost for overnight stay
06-Oct Comfort Inn
11
Candidate’s use of own vehicle
Supplies for election night party
Thank you for support Ad
09-Oct -Ialifax Herald
08-Oct NSLC
Cake for meet & greet
-
15-Se1’ Superstore
07-Sep Bell Aliant
23-Sep Various
election for close up purposes)
Communications Sept 7- Oct 8
Clerical staff Sept 7 Oct 9
Signs & posters (30% put up
before election call and remaining
after)
15-Aug Signs are Us
Brochures (50% used before
20-Aug Brochures are Us election call and remaining after)
Mileage reimbursement for use of
vehicle to put up signs
08-Sec Jones, Ted
10-Aug Smith, Henry
07-Sep Smith, Henry
OfficespaceAug 10-Sept6
(record on form 2-3B only)
Office space Sept 7 Oct 9
10
7
6
5
3
4
1
2
Expenditure
0.00
20.00
5.00
350.00
200.00
50.00
45.00
16175.68
241 68
20000
200.00
20000
2000.00
50.00
102.00
300.00
45.00
200.00
5.00
500.00
652.00
1,000.00
200.00
?,450.0O
170.00
50.00
200.00
220.00
55.00
50.00
87.00
12.00
12.00
200.00
75.00
75.00
350.00
20.00
75.00
250.00
3,491.68
191.68
200.00
2000.00
100.00
200.00
200.00
350.00
3,400.00
400.00
75.00
,,i-t,nn
400.00
600.00
A vertising
17
Non-Election Non-Election
expenses Pm
expenses
writ period
Writ period
and post
Personal Exp
of Candidate
Other
Functions
Travet
P blicltyl
800.00
52.00
100.00
500.00
Worker
Remuneration
Headquarter
Expenses
3000.00
500.00
Contributed
Services
‘000.00
250.00
Discounts
(including
used signs)
10000.00
600.00
100.00
Uncontested
Expenses
500.00
Unpaid and
Paid
Election Expenses
16
15
14
13
12
xxx Party
1&Dec-13
1
Description of Expenditure
10
9
Payee Name
8
Date of
7
8)
Doc #
6
4
3
2
1
5
Party Affiliation
1 (if any)
Halifax Area
Electoral District
(
Date
EleclionsAct Section 229
Election and NonElection Expenses for Candidate Form 2-3E
Charles Smith
Non CASH Expenses
SAMPLE ONLi
Candidate Name
(Please pnnt)
SCOTIA
ELECTIONS
I,“% NOVA
SAMPLE ONLY
)ke’ ELECTIONS
“
Financial Return for Candidate
Summary of Election Expenses
NOVA SCOTIA
Form 2-3F
Elections Act Section 229
(Please ptnt)
Candidate Name
Charles Smith
Electoral District
Halifax Area
1
Date
15-Dec-13
Party Affiliation (if any)
Headquarters Expenses
xxx Party
652.00
2 Worker Remuneration
1,000.00
3 Publicity/Advertising
7,450.00
4 Travel
170.00
5 Campaign Functions
220.00
6 Other
55.00
7 Personal Expenses of Candidate
87.00
Subtotal
8 Discounts: example, rent paid less than market price
9634.00
500.00
9 Contributed Service
10 Disputed Claims
11 Other
Total
Number of Electors on the List of Electors
11,797
Maximum Election Expenses Permitted
Official Agent (please print)
SU
C
5
n
10,134.00
63,427.70
Signature
ne
This completed form shall be posted on www.electionsnovascotia.ca within 10 days of receipt, in accordance
with the Elections Act Section 229(4).
SAMPLE ONLY
)
“%
ELECTIONS
Financial Return for Candidate
Candidate’s Balance Sheet
NOVA SCOTIA
Form 2-4
Elections Act Section 230(11(a)
(Please print)
Candidate Name
Charles Smith
Electoral District
Halifax Area
15-Dec-13
Date
Party Affiliation (if any)
xxx Party
Assets
3,124.32
Cash
10,025.68
Accounts Receivable
Other Assets
Total Assets (a)
13,150.00
Liabilities
350.00
Accounts Payable
OverdraftlLoan (Form 2-3D)
Other Liabilities
Total Liabilities
Surplus/(Deficit) (Form 2-3)
350.00
12,800.00
Opening Surplus (if applicable)
Total Liabilities & Surplus/Deficit (b)
Note: A must equal B
This includes anticipated election expenses reimbursement, nomination fee reimbursement & audit fee
tariff reimbursement.
13,150.00
**
SAMPLE ONLY
,
ELECTIONS
‘
Report Respecting Tax Receipts
NOVPt SCOTIA
Form 2-5
for Candidate
£ietion At Saction 235
(Please punt)
Candidate Name
Charles Smith
Electoral District
Halifax Area
Date
7-Nov-13
Party Affiliation (if any)
xxx Party
All receipts are to be accounted for. Unused receipts are to be returned to Elections Nova Scotia Returning Officer.
-
Part I
I have received the following Tax Receipts from Elections Nova Scotia:
IDate
Signature:
Signed by the official agent of the Candidate:
Receipt Numbers starting from
500001
15-Sep-13
500050
Part 2
I have issued, canceled or have on hand the following Tax Receipts:
Receipt Numbestarthg from
Issued
To
15-Sep-13
500001
500002
30-Sep-13
500003
500003
8-Oct-13
500004
500004
Canceled or Voided
Receipt Numbers starting from
To
.
500005
7-Oct-i 3
Unused
500005
Receipt Numbers starting from
To
500006
500050
Declaration
L(
5
I am the Official Agent of
iCYS
of
declare that
CVc-v
I declare, to the best of my knowledge and belief, that the Information contained In this report is complete, true and accurate and is
in compliance with the Elections Act.
Date
Date
1’.csi —L3
Signature of Official Agent
Signature of Returning Officer
SAMPLE ONLY
Financial Return for Candidate
Form 2-6
Notification of Disposal of Excess Contributions
EIection Act SectIon 232
ue within one month following receipt of candidate’s eleion expenses reimbursement.
—
Due with two mohts following date candidate expenses were filed, if no re-imbursement is payable.
(Please pnnt)
Candidate Name
Chailes Smith
Electoral District
Halifax Area
Date
6-Mar-14
Party Affiliation (if any)
xxx Pady
Income:
A
=
Reconciled Bank Account at time of return
B
=
Reimbursement from Elections Nova Scotia
C
=
Costs
3,124.32
10,025.68
1. Auditor’s fees in excess of amount reimbursed
2. Bank_charges
3. Payment of invoices subsequent to filing of report
350.00
4. Repayment of loans
5. Costs associated with recount
C
D
=
=
Total Costs
350.00
A+B-C Excess Contributions Issued
12,80000
Excess Contributions returned to:
/
7
LY
ECCCd
Thl54ciC
Name of Electoral District Association for the candidate who is representing the party.
Name of Registered Party if no Electoral District Association established.
Minister of Finance for the Province of Nova Scotia.
No Excess Contribution
I declare that all outstanding invoices have been paid.
Signature of Official Agent
Date