return of electoral donations and expenses · • the total amount of the contributor's...

RETURN OF ELECTORAL DONATIONS AND EXPENSES (Under section 112A of the Local Electoral Act 2001]

Councillor [Expenditure limit - $7,000)

at the by-election held on 17 February 2015, make the following declaration:

PART A: RETURN OF ELECTORAL DONATIONS {inclusive of GST)

I make the following return of all electoral donations received by me that exceed $1,500:

Set out the following details in respect of every electoral donation received (other than an anonymous electoral donation) that, either on its own or when aggregated with all other donations made by or on behalf of the same donor for use in the same campaign, exceeds S 1,500 in sum or value:

• the name of the donor;

the address of the donor;

• the amount of the donation or, in the case of aggregated donations, the total amount of the donations;

• the date the donation was received or, in the case of aggregated donations, the date that each donation was received.

NB: Section 103A Local Electoral Act 2001 defines "donation" as money or the equivalent of money or of goods or services or of a combination of those things used in the candidate's election campaign over $300 in value. It excludes labour and goods and services that

nrr\\11r1on free of charge reasonably valued at $300 or less.

* set out here if the donation is funded from contributions Total

Set out the following details in respect of every anonymous electoral donation received that exceeds S 1,500:

• the date the donation was received;

• the amount of the donation;

the specific election campaign to which the donation was designated (see top of page);

• the amount paid to the electoral officer and the date the payment was made.

NB: Section 103A Local Electoral Act 2001 defines "anonymous" as a donation made in such a way that the candidate who receives the donation does not know the identity of the donor, and could not, in the circumstances, reasonably be expected to know the identity of the donor.

ANONYMOUS DONATION DESCRIPTION {include goods or services)

Please tum page for more Electoral Donations, Electoral Expenses and Declaration Total

In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds $1,500 in sum or value:

• the name of the contributor;

• the address of the contributor;

• the total amount of the contributor's contributions made in relation to the donation.

NB: Section 103A Local Electoral Act 2001 defines "contributions" as money or goods or services that have been be applied to, or included in an electoral donation (for contributions to trust funds or a t11n,dra1i'>ir111

PART B: RETURN OF ELECTORAL EXPENSES (inclusive of GST)

I make the following return of all electoral expenses incurred by me:

Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect of any electoral activity: • the name and description of every person or body of persons to whom any sum was paid; • the reason that sum was paid. Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately

headings.

REASON for EXPENSES

Total

Dated at ! ;l_Q / Otf-/ IS- - {tJcnrdCt this day of 2015.

Signature &7~~~ ~~~~=-=-~=~~=~i THIS FORM IS REQUIRED TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,

PO BOX 54, WAIROA 4160, BY 20 APRIL 2015.

RETURN OF ELECTORAL DONATIONS AND EXPENSES [Under section 112A of the Local Electoral Act 2001)

.......... \ I) I, I rJo~ J '6rvce L~aatefor Councillor

v I ... (Expenditure limit - $ 7,000]


PART A: RETURN OF ELECTORAL DONATIONS (inclusive of GST)

I make the following return of all electoral donations received by me that exceed S 1,500:

Set out the following details in respect of every electoral donation received {other than an anonymous electoral donation) that,

either on its own or when aggregated with all other donations made by or on behalf of the same donor for use in the same campaign, exceeds S 1,500 in sum or value: . the name of the donor;

• the address of the donor;


• the date the donation was received or, in the case of aggregated donations, the date that each donation was received .

NB: Section 103A Local Electoral Act 2001 defines "donation" as money or the equivalent of money or of goods or services or of a combination of those things used in the candidate's election campaign over $300 in value. It excludes labour and goods and services that are provided free of charge reasonably valued at $300 or less.

-

1 NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* ~NATION

7ceived Amount _,.

/

~()Arll.~-::;, ~ / r~t' "C~ /

~ \ / ' I lP.( .... .., .. ~ • I.. - • •• . ·,1

·~ _,,_..

J / A COUNC\\.. ~ /

/ /


Set out the following details in respect of every anonymous electoral donation received that exceeds S 1,500: . the date the donation was received; . the amount of the donation; ,/

the specific election campaign to which the donation was designated (see top of page); • . the amount paid to the electoral officer and the date the payment was made .


ANONYMOUS DONATION DESCRIPTION (include goods or services) PAID ,JO ELECTORAL OFFICER Date received Amount /te paid Amount

v /

/ /

/ /

/ /

Please tum page for more Electoral Donations, Electoral Expen; fs and Declaration Total

. In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, -either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 in

sum or value:

• the name of the contributor; . the address of the contributor; . the total amount of the contributor's contributions made in relation to the donation .

NB: Section 103A Local Electoral Act 2001 defines "contributions" as money or goods or services that have been given to a donor to fund, be applied to, or included in an electoral donation (for example, contributions to trust funds or a fundraising collection).

NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION

Date received Amount

/ /

/ /

/ * ·s{t out here the electoral donation this contribution applies to.

I Total

-PART B: RETURN OF ELECTORAL EXPENSES (inclusive of GST)


Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect

of any electoral activity:

• the name and description of every person or body of persons to whom any sum was paid;

• the reason that sum was paid.

Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately

and under separate headings.

NAME and DESCRIPTION REASON for l PENSES EXPENSES PAID -w D(

-1/o_~?r QfJO - fl

D I /'\/ -

Wa_, '("A c:f(l.,J AJS:ul~ < --o 75 u ( )

./7 i

~ Total ft 027

'\ r , _ I

Dated at I f/v!l1f o~ /' t~ I day of ~ ~~ I 2015. / '/ " (

Signature I ( II/~ VLif I ---- .,. \'!

THIS FORM IS REQUIRED T0

1

BE C~ETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,

PO BOX 54, WAIROA 4160, BY 20 APRIL 2015.

RETURN OF ELECTORAL DONATIONS AND EXPENSES !Under section 112A of the Local Electoral Act 2001)

a candidate for




Set out the following details in respect of every electoral donation received (other than an an either on its own or when aggregated with all other donations made by or on behalf of the same donor

I exceeds $1,500 in sum or value:

1 • the name of the donor;


the amount of the donation or, in the case of aggregated donations, the total amount of the donations;

the date the donation was received or, in the case of aggregated donations, the date that each donation was received.


,---

' n~N_A_M_E_a_n_d_A_D_D_R_ES_S_o_f_D_O_N_O_R __ +--D_ES_C_R_IP_T_IO_N_ (in_c_lu_d_e_go_o_d_s _or_s_e_rv_ic_es_)*_-+-----D~O_N_A~T_IO_N ___ ___,


[ ______ _,__ ___ _ I I

I c -·---L - ~---------· i------1

L-~ f- +-

I--~--~----+------·· -* set out here if the donation is funded from contributions Total ~ _

Set out the following details in respect of every anonymous electoral donation received that exceeds $1,500:

the date the donation was received;

the amount of the donation;


the amount paid to the electoral officer and the date the payment was made.


ANONYMOUS DONATION DESCRIPTION (include goods or services) PAID TO ELECTORAL OFFICER Date received Amount Date paid Amount

~-------+-------,---- ---------

Please turn page for more Electoral Donations, Electoral Expenses and Declaration Total

. .

(

~~he case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, " I either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds $1,500 in '

sum or value: I

1 • the name of the contributor;

the address of the contributor;

the total amount of the contributor's contributions made in relation to the donation.

NB: Section 103A Local Electoral Act 2001 defines "contributions" as money or goods or services that have been given to a donor to fund,

1 be applied to, or included in an electoral donation (for example, contributions to trust funds or a fundraising collection).

' NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION Date received Amount

* set out here the electoral donation this contribution applies to. Total



Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect , of any electoral activity:

I l

'

I

I

• the name and description of every person or body of persons to whom any sum was paid; • the reason that sum was paid. Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately and under separate headings.

NAME and DESCRIPTION REASON for EXPENSES EXPENSES PAID

Dated at

Signature

C-~C.<L. "°""''"-'~~e>J <F\_.~ l "1.A ~O I

~ Ne0.s~Mlal. f't-()Vc:Y2.4'1.,S-\~ -I -- -~:q oc. --< --+----------- --- --- -·-- +--- --------

f~~~-------<--~~_h.'Xlc_1o __ q_d_\_N_~ ______ +-----'-~~-------q_C\~~

tL·.

-! I I

-

I

-- -- -·----·- ---- -- ---·

I I I I I i I I I I I I I

Total

day of

BE COM l'ETED {EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,

PO BOX 54, WAIROA 4160, BY 21APRIL2015.

----I

I

------1

2015.

J

RETURN OF ELECTORAL DONATIONS AND EXPENSES (Under section 112A of the Local Electoral Act 2001 I

I, I <5£.AN 6f)SKtN I a candidate for Councillor [Expenditure limit - $7,000]


PART A: RETURN OF ELECTORAL DONATIONS (inclusive of GST) ~


Set out the folloyving details in respect of every electoral donation received (other than an anonymous electoral donation) that, either on its own or when aggregated with all other donations made by or on behalf of the same donor for use in the same campaign, exceeds $1 ,500 in sum or value: . the name of the donor; . the address of the donor;




NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION Date received Amount

k( Al ROA RocK CHuRct-1 f"l. rlod"JlAtJ 1--- tL~" \. l JKY\ 14·-1.2.-14 t2001 ()0

DEL H} STRE.E-1 v I - -IJAIROA

I

• set out here if the donation is funded from contributions Total '$2-oo~ca


• the date the donation was received;

• the amount of the donation;

• the specific election campaign to which the donation was designated (see top of page); . the amount paid to the electoral officer and the date the payment was made .



~p(")/1 ru ~ ,--~.-"

- 1--'lf?;~

1 ( 7 A !)'j I. r'

1'-1 ....... ... _ \ ~.

~ . , . . ·) A,

CouNc ,\..


I · In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, ~

either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 in sum or value:

. the name of the contributor; . the address of the contributor;

• the total amount of the contributor's contributions made in relation to the donation .


NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION Date received Amount

* set out here the electoral donation this contribution applies to. I Total CJ



Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect of any electoral activity: • the name and description of every person or body of persons to whom any sum was paid; • the reason that sum was paid. Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately and under separate headings.


lJi1iiLJfl_~1Tu-=:fru1t1hl£ 2lJ 't RQ_foSir~ · l'ei BDVfR/ tst ~2/ , ()() [klf)_~p_ Cr]J- fi'1~<; CAHPR/6J'11 ~us 1 ~ Nf~SPf!fEK l-:i21)f; ~(J()

Total 1;220~ 00

Dated at I I 0~27a-/rn I this I ·71'1-J I day of I ~PRlL I 2015. - ~

Signature I ~\~- I ~ -

l 'i \ -THIS F~M IS ''" ~ ·~~E COMPLETED (E~IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,

PO BOX 54, WAI ROA 4160, BY 20 APRIL 2015.

RETURN OF ELECTORAL DONATIONS AND EXPENSES [Under section 112A of the Local Electoral Act 2001)

a candidate for




Councillor [Expenditure limit - $7,000]

Set out the following details in respect of every electoral donation received (other than an anon either on its own or when aggregated with all other donations made by or on behalf of the same don exceeds $1,500 in sum or value:

the name of the donor;


the amount of the donation or, in the case of aggregated donations, the total amount of the donations;



t\IAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION Date received



the date the donation was received;




Amount


ANONYMOUS DONATION DESCRIPTION (include goods or services) PAID TO ELECTORAL OFFICER Date received Amount Datepafd Amount


r- ----- -

In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, ' either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds $1,500 in

sum or value:

the name of the contributor;

the address of the contributor;

the total amount of the contributor's contributions made in relation to the donation.

NB: Section 103A Local Electoral Act 2001 defines "contributions" as money or goods or services that have been given to a donor to fund, _ be applied to, or included in an electoral donation (for example, contributions to trust funds or a fundraising collection).

1 NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION r --- -- - ---- ------ --+---=-oa-te- re-ce-,-i«-ed-,------+--Am--ou-nt __ __.

~--- -------------- - ------1 _____ , -------t-- ----i

t ---v/;i . -~ t 1v)1+ ~~ ~ J --=·~-· !Jt+. · ~~ ~- -- -- ----- --+-- - --------- ~--- ---+ ~- ----- -- ----- -----1-- - ---------------- -- i ----- ---L- - -------~

[r -- -- -- - -----_ -- -; set out he-re t_h_e_e~-ect_o_ra_l doo.,ioo "''' ~'""''°" """" J :-._-l- -_-_· ~~t.Ci - -_: - ------ - - -- ---------- ----

; PART B: RETURN OF ELECTORAL EXPENSES (inclusive of GST)

: I make the following return of all electoral expenses incurred by me:

ii Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect

of any electoral activity: I • the name and description of every person or body of persons to whom any sum was paid; 1 • the reason that sum was paid.


' and under separate headings.

REASON for EXPENSES

I

---__ · j -. EXPENSES PAID

. jwcL c;c,j "119 . .fO

LuL " t ,~g. 1D --,

I -+- - --

I

I I I ~

I

~

: ___ _ I ________________ i

Total Soi . io ; - - - --- ---~----·

Dated at - _ 2_'5 ~l --~:----. this ' Wt~/ day of ---t1Af<..e// --. 2015.

Signature ~- ~ /1 ~ --:;Jj ~ ___ - ~-=-~ THIS FORM IS REQUIRED TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,

PO BOX 54, WAI ROA 4160, BY 21APRIL2015.

I

[ r--

RETURN OF ELECTORAL DONATIONS AND EXPENSES (Under section 112A of the Local Electoral Act 2001)

I a candidate for



Councillor [Expenditure limit - $7,000]


Set out the following details in respect of every electoral donation received (other than an anonyjl!l~~m~ either on its own or when aggregated with all other donations made by or on behalf of the same d exceeds S 1,500 in sum or value: • the name of the donor;


the amount of the donation or, in the case of aggregated donations, the total amount of the dona

the date the donation was received or, in the case of aggregated donations, the date that each donation was rece e .


NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION

A ), /)


11/ti __:,---

• set out here if the donation is funded from contributions Total

Set out the following details in respect of every anonymous electoral donation received that exceeds S 1,500: !{/~ • the date the donation was received;

( the amount of the donation; the specific election campaign to which the donation was designated (see top of page);




/l

A I i-J--/Vf-!-- ..-

~


In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, either on it's own or whe9, a~~at~d v;ith other contributions made by the same contributor to the donation, exceeds S 1,500 in

sum or value: /l/&7\./-e the name of the contributor;





• set out here the electoral donation this contribution applies to. Total



Set out the following details in respect of every electoral expense incurred by or on behalf of the candidate at the election in respect of any electoral activity: • the name and description of every person or body of persons to whom any sum was paid; • the reason that sum was paid. Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately and under separate headings.


Dated at

Signature

Total S2?J i

dayof I /C(Mc/t_, I 201s.

M IS REQUIRED TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,


.. ~ RETURN OF ELECTORAL DONATIONS AND EXPENSES

[Under section 112A of the Local Electoral Act 2001)

I, _I __ .:k,~yi_e_~~~'+-------+/b.Y~~~A~u/~--~I a candidate for




Councillor (Expenditure limit - $7,000]

Set out the following details in respect of every electoral donation received (other than an ~~rS?@if~ t, either on its own or when aggregated with all other donations made by or on behalf of the same nor for use in the same cam{ai

exceeds S 1,500 in sum or value: ~ 2 5 FEB • the name of the donor; 20f5 • the address of the donor;

the amount of the donation or, in the case of aggregated donations, the total amount of the do OUNC\\.-• the date the donation was received or, in the case of aggregated donations, the date that each donation was , 1::u::i vcu.


j __ N_ A_M_E_a_n_d_A_D_D_R_E_S_S_o_f _D_O_N_O_ R __ -+-D_E_S_C_R_IP_T_IO_N_' _(in_c_lu_a_'e_g_o_o_ds_o_r_s_erv_ ic_es_)_* -1---~-~-D~O_N_A~T_l_O_N~-----1 ( Date received Amount

--

• set out here if the donation is funded from contributions Total


(J . the date the donation was received;



the amount paid to the electoral officer and the date the payment was made .

. •



Please tum page for more Electoral Donations, Electoral Expenses and Declaration Total o .. oo

A . • / l .. In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that-,

either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 in ;

sum or value:



• the total amount of the contributor's contributions made in relation to the donation .


NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION


• set out here the electoral donation this contribution applies to. I Total o. c.0 0 -










AY11JtV S1/JtllS J{!J 'b::nd~ /)1or15 /26$ ·Do (;J'- ) (51 Vf d' fl.dutJ~/<; 'x c!z.. -:34/. zo w 1rm ~r(Je, s, ~ ~~ 262 .s-o {})fJJ~ trt- t..ealvk fiFDr Uo~ [OO-~ (

J

Total 1?b<& . ru Dated at I f.JaJ.f'ex:t this . I 21 I day of I KiJ (l({).,t1(/ I 2015 .

Fl F , J

Signature I f!tl//d/k/D,/ I

T'/, FORM~S REQU IRED TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,


'

RETURN OF ELECTORAL DONATIONS AND EXPENSES [Under section 112A of the Local Electoral Act 2001]

I, Q)et\JyS $. ~ I a candidate for Councill ~

[Expendit~oP'JcfPIST~ at the by-election held on 17 February 2015, make the following declaration: ~~f

. ~

PART A: RETURN OF ELECTORAL DONATIONS (inclusive of GST) ~ 2 2 FE9 20i5 I make the following return of all electoral donations received by me that exceed S 1,500:

Set out the following details in respect of every electoral donation received (other than an an ous ~~{rLd~~ion ' either on its own or when aggregated with all other donations made by or on behalf of the same donor , ,paign,

exceeds S 1,500 in sum or value:






NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION

J.f .. 4 Date received Amount


Set out the following details in respect of every anonymous electoral donation received that exceeds S 1,500: . the date the donation was received;

y: the amount of the donation;

the specific election campaign to which the donation was designated (see top of page); . the amount paid to the electoral officer and the date the payment was made. -


ANONYMOUS DONATION DESCRIPTION (include goods or services) PAID TO ELECTORAL OFFICER

Date received Amount Date paid Amount

!YA


' In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that,

either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 irf

sum or value:


• the address of the contributor; . the total amount of the contributor's contributions made in relation to the donation .


. NAME and ADDRESS of CONTRIBUTOR DESCRIPTION (include goods or services)* DONATION CONTRIBUTION

NA. Date received Amount

·-

* set out here the electoral donation this contribution applies to. I Total

-PART B: RETURN OF ELECTORAL EXPENSES (inclusive of GST)









WMk'AA sr~/lvtl3n;A-} A-1) vM:rr &t MhVT c~/S-K ~ Jo \._ / I

,

(

Total €f 1sg . 70 Dated at I A/A1i&J1 I this l-Z3~ I day of l ~~A-fUi-1 I 2015.

Signature I~- .,,.,,. ~-- I "'-..

__.,,., THIS FORM I.:> r<.c'-.!ulKtu TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,


(

RETURN OF ELECTORAL DONATIONS AND EXPENSES (Under section 112A of the Local Electoral Act 2001)

I a candidate for




Set out the following details in respect of every electoral donation received (other than an nymous electoral donatio

either on its own or when aggregated with all other donations made by or on behalf of the same doi'n!!lii~~~~~~~m exceeds S 1,500 in sum or value:






l NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION


2 lON G-ftt1v1) r!:- N 5 (J(J 4 lf [HG-fl.[

Jcft.,v c LC f Wf.}/~J, fill NI INC- Jo-}..-/$' 3o - j - /) 'So - oo

* set out here if the donation is funded from contributions Total ')o - PO


• the date the donation was received; . the amount of the donation;

• the specific election campaign to which the donation was designated (see top of page); . the amount paid to the electoral officer and the date the payment was made .


ANONYMOUS DONATION DESCRIPTION (include goods or services) PAID TO ELECTORAL OFFICER

Date received Amount Date paid Amount

-t\ 1 /"\ 7' r r; (\J tJ I '-

rt-' l __..


In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, L

either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 in

sum or value:


• the address of the contributor; . the total amount of the contributor's contributions made in relation to the donation .



"' r ~

r, (, (--: I' wv J ~

I ~ I \ I r·"J I

• set out here the electoral donation this contribution applies to. I Total (










/-:_ ( r--1 u -

r~ D' \

--

' . \ l t':'--l -I

Total

Dated at I 1 UIJ ~ o'L(J5 this I 1'f,-f tt fl} 7J rt y I day of I I cq - 0 2-. - I 2015. I I JI

Signature I , A I TH IS FORM IS REQUI . O~E ~OMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,


l

0

RETURN OF ELECTORAL DONATIONS AND EXPENSES [Under section 112A of the Local Electoral Act 2001]

'· I fvwov 1o/l 1 l')ctQ,v'<U I a candidate for Councillor [Expendit~,J{O~lc-~

at the by-election held on 17 February 2015, make the following declaration: r~p>·- -'"''c~ PART A: RETURN OF ELECTORAL DONATIONS (inclusive of GST)

I make the following return of all electoral donations received by me that exceed S 1,500: ~ 2 0 FES 2015 t Set out the following details in respect of every electoral donation received (other than an a mous electoral donation) th either on its own or when aggregated with all other donations made by or on behalf of the same don €OUf.f~eca gn, exceeds S 1,500 in sum or value:






NAME and ADDRESS of DONOR DESCRIPTION (include goods or services)* DONATION Date received Amount

* set out here if the donation is funded from contributions Total -·

Set out the following details in respect of every anonymous electoral donation received that exceeds S 1,500: . the date the donation was received; . the amount of the donation; . the specific election campaign to which the donation was designated (see top of page); . the amount paid to the electoral officer and the date the payment was made .



Please turn page for more Electoral Donations, Electoral Expenses and Declaration Total -

In the case of any electoral donation funded from contributions, set out the following details in respect of each contribution that, either on it's own or when aggregated with other contributions made by the same contributor to the donation, exceeds S 1,500 in

sum or value:






• set out here the electoral donation this contribution applies to. I Total -~ ' ----- ...,~_.)




of any electoral activity: • the name and description of every person or body of persons to whom any sum was paid; • the reason that sum was paid. Sums paid for radio broadcasting, television broadcasting, newspaper advertising, posters, pamphlets etc must be set out separately


NAME and 9iESCRIPTION

this

~ REASON for EXPENSES EXPENSES PAID

(

Total (j ;2,0{)/ 00 --,

[io 1

l dayof I fahvua@ 1fw81 tVhtuu~ ..

THIS FORM IS REQUIRED TO BE COMPLETED (EVEN IF IT IS A NIL RETURN) AND PROVIDED TO THE ELECTORAL OFFICER,


0

2015.

return of electoral donations and expenses · • the total amount of the contributor's...

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