08/31/2015 7:39 AM FAX 7804607964 £ PAULS HOLDINGS 10002/0002 Cultivate Life BY-ELECTION 2015 SELF-FUNDED CAMPAIGN VOLUNTARY STATEMEN Local Jurisdiction: City of St. Albert, Province of Alberta for June 2^, 2015 By-election Full Name of Candidate: Candidate for Election as: (circle one) E,U"Z/\(^Q H Mayor Councillor This is to confirm that I have funded my cai|npaign completely from my own personal resources to an amount that did not exceec $10,000 and have not accepted contributions from any other person or enti ty. Therefore, pursuant to section 147.11 of the Local Authorities Election Act; R.S.A. 2(100,1 am not filing a disclosure or financial statement. Signatu&tof Candidate Chun >UOr 31 /Ifift Date ofSEinature The personal information that i9 being collected under the authority of the Local Authorities Election Act will be used for the purposes under (hat Act, It «s protected by the privacy provisions of the Fmedom of I iformation and Protection of Privacy Act. If you have any questions about the collection, contact the City's FOIP Coordinator at 780-459-1500.
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