b stefani · \\,c\ci .\='kqe \c tbc rfiidential address (city/town, street address, if nomf...

$: B SteFanI · \\,c\ci .\='kqe \c tbc rfiidential address (city/town, street address, if nomf naiing as a #spent elecror r r\ properw aodress (city/town, +rreet address, postal code)$
CANDIDATE NOMINATION PACKAGE

C2 – Nomination DocumentsPLEASE PRINT IN BLOCK LETrERS

JURISDt.CTION (E.G. MUNICIPALITY, REGIONAL DISTRICT)

v \ Ctc I \ (AELECriON AREA (E.G. MUNICIPALITY, REGIONAL DISTRICT ELECrORAL AREA)

\ \CI OF \ Cd

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NOMINEE’S LAST NAME

He\( c\w\ c\nFIRST NAME

SteFanI eMIDDLE NAME(S)

USUAL NAME OF PERSON NOMINATED IF DIFFERENT FROM ABOVE AND PREFERRED BY THE PERSON NOMINATED TO APPEAR ON THE BALLOT

<DIe (-C\ t\ \ e \lac aN\ C,\ nRESIDENTIAL ADDRESS (STREET ADDRESS) CITY/TOWN

N \ Cl Of ICAPOSTAL CODE

MAILING ADDRESS IF DIFFERENT FROM RESIDENTIAL ADDRESS

(STREET ADDRESS/PO BOX NUMBER)CITY/TOWN POSTAL CODE

As a Candidate for the office of

POSITION (E.G. MAYOR, COUNCILLOR, DIRECTOR)

C Our\C\\\ c rJURISDICTION (E.G. MUNICIPALITY, REGIONAL DISTRICT)

\ ICI art Cl

Each of us affirms that to the best of our knowledge, the above named person nominated for office:

1. Is or will be on general voting day for the election, 18 years of age or older.2. Is a Canadian citizen.

3. Has been a resident of British Columbia. as determined in accordance with section 67 of the LocalGovernment Act, for the past six months immediately preceding today’s date.

4. Is not disqualified under the Local Government Act or any other enactment from being nominated for, beingelected to or holding the office, or is not otherwise disqualified by law

NOMINATOR'S NAME (FIRST, MIDDLE AND LAST NAMES)

A „ ctr c'Jf{ \ CLA

NOMINATOR'S NAME (FIRST, MIDDLE AND LAST NAMES)

C .', 4les i>cs/ml.a6,\ d:„.br,RESID{NTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

F NOMINATING AS A.RESIDENT ELECrOR

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR

PROPERTY ADDRESS tCITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPERTY ADDRESS (CITY/yawN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMINAI#S SIGNA

Please see over for additional space when more than two nominators are required. For local governmentsthat require 25 nominators attach an additional sheet as necessary.

I consent to the above nomination for office

DATE: (YYYY / MM / DD)

'J. ; ''/

ORIGINAL – Victoria By-election December 2020PLEASE KEEP A COPY FOR YOUR RECORDS

C2 – Page 1 of 3 This form is available for public inspection


MIDDLE AND LAST NAMES)

Cb

NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

tb\.\l \( nvl;D SS (CITY/TOWN. STREET ADDRESS, POSTAL CODE)IF NOMINATIN6 AS A RESIDENT ELECTOR

=mESS (CITY/TOWN, sI}REET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECro

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, dSTAL CODE)

IF NOMINATING AS A NON-RESIDENT PROPERTY ELECrORMOPERTV ADDRESIICIIY/TOWN,€TREET ADDR[SS, b&STAL COD/E)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECrOR

N(mNATOR’SSIGNATURE NOMINA

NmATOR’S NAME.(FIRST, MIDDLE AND LAST NAMES)

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PROPERTY ADDRESS (CITYrTUWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

E

RE51DENTEAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

"~PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

’S SIGNATUREN

6QMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES) NOMtNATOR’S NAME (FIRST, MIDDLE AND LAST NAMES

A/\:\\': b \\\c K : \ LL (F. _ ,af<RESIDENTIAL ADbRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

" NO

WIF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPER rY ADDRESS (CiTY/-TOWN, SIREET ADDRESS, PC-JSTAL CODEIF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMINATOR’S SIGNATURE NOMINATOR’SSIGNATLI RE

NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES) NOMINATOR'S NAME (Fl-IST, MIDDLE AND LAST NAMES)

11ok-rlRES[DENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)A NON-RESIDENT PROPERTY ELECTORIF NOMINATtN

mI NATi;T;SlbNATURE

(CITY/TOWN, STREET ADDRESS, POSTAL CODE)PROPERTY ADDPROPERTY E ORLqATIN6 AS A NOIF NO

NOMINATOR’S NAME (FIBIT, MIDDLE AND LAST NAMES I

nar eC,/ (ZcxIeC icl KerrNOMINATOR'S NAME (FIRST, MIDDLE AND LAST NAMES)

IEd c+tQsR$he hE tkEIaRESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

IF NOMINATING AS A RESIDENT ELECrOR

PROP£RTV A;dR£SS (clrv/TOWN, dtET AODdESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPkRtV ADDRESS (aw/TOWN, STREET ADDRESS, POSTAL CODk)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

N

ORIGINAL – VIctoria By-election December 2020PLEASE KEEP A COPY FOR YOUR RECORDS

C2 – Page 2 of 3 This form is availabie for public inspection•

ii&@VW]NOMENATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

B\ ? Our\C\ t \\\ \ bnf\e tAe it ! qq aNOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

\fP&~RnIb V CAr\ r\\< f Pt,\RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

.\='KQe \\,C\CI \c tBCRfIIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS,

IF NOMf NAIING AS A #SPENT ELECrOR r r\PROPERW AODRESS (CITy/TOWN, +rREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECrOI

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

IF NOMINATING AS A NON-RESIDENT PROPERIY ELECTOR+

NOMU\LATOR’S SIGNATURE NOMINATI IATU RE

NOMINATOR’S NAdE (FIR4r, MIDDLE AND LAST NAMES)

:bytE Lk EL,ISt, A\bPV,\ CIANRESIDENTiAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECrOR

i. V€V.?,'tC= VI

JN AND LAST NAMES) /RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)

" PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR +,--

PROPERTY ADDRESS (cnr/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMINATO R’S SIGNATURE NOMINATOR’S SIGNATURE

NOMINATOR’S NAME (FiRST, MIDDLE AND LAST NAMES)

IS c + 'Oh .'J L-

NOMtNATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

S 'f 'I„ v-/ # #/ O/ ddt,ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE) RESIDENTIAL ADDRESS {CITY/TOWN, STREET ADDRESS, POSTAL CODE)

IF NOMINATING AS A RESIDENT

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPERTY ADDRESS (aw/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

maR fRE NOMINATOR’S SIGNATURE

NOMINATOR’S NAME (FIRST. MIDDLE AND LAST NAMES) NOM}NATOR'S NAME (FIRST, MIDDLE AND LAST NAMES)

FI\( I=ADDRESS, POSTAL CODE)FDENTEAL ADDRESS (CITY/TOWN

IF NOMINATING AS A RESIDENT ELECTOR

'\

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESI

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CO .dIF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPERTY ADDRESS (aTV/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMtNATOR’S SIGNATURE NOMINATOR

NOMfNATOR'S NAME (FIRST. MIDDLE AND LAST NAMES) NOMINATOR’S NAMr (FIRST, MIDDLE AND LAST NAMES)

F\ ! \: ' ;-_C\ ,' ; b’ f £:(_i \ U 'i’ JILl kRESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)F NOMINATING AS A RESIDENT ELECTOR

PROP£RTY I TR££T AODRESS, POSTAL COD£)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECrOR

PROPERTY ADDRESS (CiTY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NO PERTY ELECTOR

NOMINA bTU RE NC)MINATOR’S SIGNATURE



NOMINATOR’S NAME (FIRST, M[DDLE AND LAST NAMES) NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES) /K $ 111>C ; I ul DcLuun FlaG /C,C +r Il ( JaIL,\A £2£nb£+

amal;iiIc , STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR

/,c+arl

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMLNATING AS A RESIDENT ELECrOR

t/.'Jb#//4PROPERTY ADdRESS (CITY/TOVIN, STREET ADDRESS, POSTAL CODEIF NOMINATING AS A NON-RESIDENT PROPERTY ELECrOR

PROPERTY ADDRESS (drY/TOWN, STREET ADDRESS, POSTAL CODE)

IF NOMINATING AS A NON-RESIDENT PROPERTY ELECrOR

NOMI}gATOR’S SIGNATURE NOMINATOR’S SIGNATURE

NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES) NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

e c, t:: a+ Lr\ 1 h, C\dIrk ‘ IW (\+a b4ALt,\lq -CtF ALRESIDENTIAL ADDRESS (CETY/FwN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECTOR ' .' 1,, ! ' c . IT b ' -

PROPERTY ADDRESS (aPr/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR


J

NOMtNA'roR’s SIGNATURE

NOM}NATOR’S NAME (FIRST. MIDDLE AND LAST NAMES)

f4110pi eRESIDENTIAL ADDR[SS (CIty/TOWN. STRE7T ADDRESS, POST’AL CODE)F NOMINATING AS A RESIDENT ELECrOR

NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

T+4'Abb „,',a, ANRESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CO

DE?q .bIF NOMINATING AS A RESIDENT ELECTOR

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)F NOMINA


NOMINATOR’S SIGNATURE

NATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

\-

NOMINAtOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IDENT ELENATING AS A

ADDRE S, POSTAL CODE)RESIDENTIAL ADDRESS (CITY/TOWN,

+IF NOMINATING AS A RESIDENT ELECrOR

fab fiaPROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMiNATING AS A NON-RESIDENT PROPERTY ELECTOR

PROPERfY ADDRESS (aw/TOWN, STREETAODRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMINATOR’S SIGNATURE

NOMINATOR’S NAME (PIRST, MIDDLE AND LAST NAM£S) NOMINATOR’S NAME (FIRST, MIDDLE AND LAST NAMES)

Fi AS4Dvb ?I//\RESIDENTIAL ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELECIOR

RESIDENTIAL /DDRESS (clrv/TOWN, STREET AtfDRBSS, POSTAL CODE)IF NOMINATING AS A RESIDENT ELEqrOR

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, POSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECrOR

PROPERTY ADDRESS (CITY/TOWN, STREET ADDRESS, PbSTAL CODE)IF NOMINATING AS A NON-RESIDENT PROPERTY ELECTOR

NOMINATOR’SSIGNATU RE




C2 – Nomination DocumentsPLEASE PRINT IN BLOCK LETrERS

I do solemnly declare as follows:

1. 1 am qualified under section 81 of the Local Government Act to be nominated, elected and to hold the office of

POSITION (E.G. MAYOR, COUNCILLOR, DIRECTOR)

CC LAb( \\\ of2. 1 am or will be on general voting day for the election, 18 years of age or older.

3. 1 am a Canadian citizen.

4. 1 have been a resident of British Columbia, as determined in accordance with section 67 of the Local GovernmentAct, for the past six months immediately preceding today’s date.

5. 1 am not disqualified by the Local Government Act or any other enactment from being nominated for, beingelected to or holding the office, or otherwise disqualified by law.

6. To the best of my knowledge, the information provided in these nomination documents is true.

7. 1 fully intend to accept the office if elected.

8. 1 am aware of and understand the requirements and restrictions of the Local Elections Campaign Financing Actand I intend to fully comply with those requirements and restrictions.

NOMINEI’S SIGNATURE

DECLARED BEFORE OR COMMISSIONER FOR TAKiNG AFFIDAVITS FOR BRITISH COLUMBIA

DATE: (YYYY / MM / DP)

''~t:;c;bz '4AT: (LO

JQ9D IIa

I am acting as my own Financial Agent I have appointed as my Financial Agent

Elt\cin her\ne itFINANCIAL AGENT'S NAME (IF APPLICABLE)NOMINEE’S SIGNATURE


C2 – Page 3 of 3 This form will be provided to Elections BC

BRITISHU COLUMBIAStatement of Disclosure

Financial Disclosure Act

You must complete a Statement of Disclosure form if you are:• a nominee for election to provincial or local government office', as a school trustee or as a director of a francophone education authority

an elected local government officialan elected school trustee, or a director of a francophone education authorityan employee designated by a local government, a francophone education authority or the board of a school district

a public employee designated by the Lieutenant Governor in Council- ("local government” includes municipalities. regional districts and the Islands Trust}

Who has access to the information on this form?The Financial Disclosure Act requires you to disclose assets, liabilities and sources of income, Under section 6 (1 ) of the Act, statementsof disclosure filed by nominees or municipal officials are available for public inspection during normal business hours. Statements filed bydesignated employees are not routinely available for public inspection. If you have questions about this form. please contact your solicitoror your political party's legal counsel

What is a trustee? – s. 5 (2)In the following questions the term "trustee" does not mean school trustee or Islands Trust trustee. Under the Financial Disclosu ro Acta trustee

• holds a share in a corporation or an interest in land for your benefit, or is liable under the Income Tax Act (Canada) to pay income taxon income received on the share or land interest

• has an agreement entitling him or her to acquire an interest in land for your benefit

Person making disclosure: \1 clr dfb.sin Stef'qrn,L/.S;.r.J

st”,t, '"”I „"t', PO,toHI'' b'” \VI ( Tat I Ot bC )

aty: \ t (Nc: r \ C+ ProvInce: P) C Postal CodeO provincial <Kcal government

Level of government that applies to you:O school board/francophone education authority

If sections do not provide enough space, attach a separate sheet to continue.

Assets - S. 3 (a)List the name of each corporation in which you hold one or more shares, including shares held by a trustee on your behalf

rJ ,„ e

Liabilities - s. 3 (e)List all creditors to whom you owe a debt. Do not include residential property debt (mortgage, lease or agreement for sale), moneyborrowed for household or personal living expenses, or any assets you hold in trust for another person

creditor’s name(s)

///4creditor’s address(es)

Income – s. 3 (b-d)List each of the businesses and organizations from which you receive financial remuneration for your services and identify yourcapacity as owner, part-owner, employee, trustee, partner or other (e.g. director of a company or society)

• Provincial nominees and designated employees must list all sources of income in the province

• Local government officials, school board officials, francophone education authority directors and designated employees must listonly income sources within the regional district that includes the municipality, local trust area or school district for which the official iselected or nominated, or where the employee holds the designated position

your capacIty

Reset*t’clr ,e’ fc.yI ,hal/? ;t rI be J'S

name(s) of business(esyorganization(5)

LIn ;re,{;b of b’;Cnn'I jh'daI/s' SGC'er7j q I d &rI L F ){ r

2

Real Property - s. 3 (f)List the legal description and address of all land in which you, or a trustee acting on your behalf , own an interest or have an agreementwhich entitles you to obtain an interest. Do not include your personal residence

• Provincial nominees and designated employees must list all applicable land holdings in the province

• Local government officials, school board officials. francophone education authority directors and designated employees must listonly applicable land holdings within the regional district that includes the municipality, local trust area or school district for which theofficial is elected or nominated, or where the employee holds the designated position

legal description(s) address(es)

A' /.4

Corporate Assets - s. 5Do you individually, or together with your spouse, child. brother, sister, mother or father, own shares in a corporation which total morethan 30% of votes for electing directors? (Include shares held by a trustee on your behalf , but not shares you hold by way of security.)

(8 no 0 yes

If yes, please list the following information below & continue on a separate sheet as necessary:• the name of each corporation and all of its subsidiaries• in general terms, the type of business the corporation and its subsidiaries normally conduct

• a description and address of land in which the corporation. its subsidiaries or a trustee acting for the corporation, own an interest, orhave an agreement entitling any of them to acquire an interest

• a list of creditors of the corporation, including its subsidiaries. You need not include debts of less than $5,000 payable in 90 days

' a list of any other corporations in which the corporation, including its subsidiaries or trustees acting for them. holds one or more shares

2D2Cl luIL?_datesignature of person making disclosure

Where to send this completed disclosure form:Local government officials:

to your local chief election officer• with your nomination papers, and

to the officer responsible for corporate administration• between the 1 st and 15th of January of each year you hold office, and

• by the 15th of the month after you leave office

School board trustees/ Francophone Education Authority directors:to the secretary treasurer or chief executive officer of the authority• with your nomination papers, and

• between the 1 st and 15th of January of each year you hold office, and• by the 15th of the month after you leave office

Nominees for provincial office:• with your nomination papers if elected you will be advised of further disclosure requirements under the

Members’ Conflict of interest Act

Designated Employees:. .. to the appropriate disclosure clerk (local government officer responsible for corporate administration,secretary treasurer, or Clerk of the Legislative Assembly)

• by the 15th of the month you become a designated employee, and

' between the 1 st and 15th of January of each year you are employed, and• by the 15th of the month after you leave your position 3

06/2014