Engagement

Campaign Information

Registered Party *

Constituency Name *

Date Form F0403 (Certificate of Nomination) issued by Elections Ontario

Date *

Financials

Total Estimated Income *

Total Estimated Expenses *

Considering the campaign financial information you entered above your estimated Audit retainer fee
to be paid from the candidates campaign bank account is:

Candidate Information

Name Prefix *

Candidate Name *

First Name

Last Name

Address

Street Address *

Street Address (2)

City *

Province *

Postal Code *

Candidate E-mail *

Home Phone # *

Work Phone #

Mobile Phone #

Chief Financial Officer Information

Name Prefix *

CFO Name *

First Name

Last Name

Address

Street Address *

Street Address (2)

City *

Province *

Postal Code *

CFO E-mail *

Home Phone # *

Work Phone #

Mobile Phone #

Please review the information you have entered.

Chaplin & Co. Chartered Accounts requires that Chief Financial Officers of candidate campaigns adopt and use specially designed MS Excel Workbooks to report various financial aspects of the candidate’s campaign. Chaplin & Co. Chartered Accountants will provide these spreadsheet tools. By checking the checkbox the Chief Financial Officer, as noted above, agrees to adopt and use these MS Excel workbook tools and provide them as completed at the time of the audit.