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MUNICIPALITY OF BROCKTON

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           SCHEDULE B
     FORMS AND NOTICES




MUNICIPALITY
OF BROCKTON
                                                                                                       2
                      TABLE OF CONTENTS – BY FORM NUMBERS
Form #     Name of Form                                                      Section          Page #

EL07       List of Certified Candidates                                      (S.11(4) 2)
EL08       Certificate of Election Results                                   (S.11(4) 3)
EL09       Final Summary of Election Results                                 (S.11(4) 4)
EL10       Appointment and Oath of DRO                                       (S.15(1)
EL11       Appointment and oath of an Election Official                      (S.15(2))
EL12(A)    Appointment of Scrutineer by Candidate                            (S.16(1))
EL12(B)    Oral Oath of Secrecy
EL14       Candidate's Declaration-Proper Use of Voters' List                (S.23(5))
EL15       Application to Amend Voters' List                                 (S.24)
EL16       Application for Removal of Another's Name from the Voters' List   (S.25)
EL17       Notice of Nomination for Office                                   (S.32)
EL18(A)    Declaration of a Qualified Candidate - Municipal                  (S.35(2))
EL18(B)    Declaration of a Qualified Candidate - School Trustee
EL19       Withdrawal of Nomination                                          (S.36)
EL20       Declaration of Acclamation to Office                              (S.37(1))
EL21       Notice of Death of Candidate                                      (S.39(A))
EL22       Certificate on Voters' List                                       (S.28(1))
EL10-FOI   Freedom of Information Release
EL24       Sample Notice of Election Information (For Newspaper Ad)          (S.40)
EL25(A)    Certificate and Receipt for Ballots                               (S.41(1))
EL26       Oath of Qualification                                             (S. 52(1) 3)
EL27       Oral Oath of Friend or Interpreter
El 27A     Oath of Elector Requesting Assistance of a Friend
EL29(A)     Voting Instructions                                              (S.52(3), (4))
EL29(B)    Voter Instructions and Sample Ballot ( E and Tel Vote)
EL30       List of Objections to Vote Count                                  (S.54(4))
EL31(A)    Statement of Election Results (Deputy Returning Officer)          (S.55(1) A)
EL32       Declaration of Election Candidate                                 (S.55(4) A)
EL34       Statutory Provisions Regulating Voting Procedures                 (S.48, 49)
EL35       Notice of Offence, Notice of Corrupt Practice                     (S.89)
EL36       Disclaimer to Right to Office                                     (S.84(1)- (3))
EL37       Certificate of Maximum Campaign Expenses                          (S.76(7))
EL38       Witness Statements as to Destruction of Ballots                   (S. 88(2))
EL39       Notice of Recount                                                 (S.56 - 58)
EL40       Recount Results                                                   (S.62(1))
EL41       Declaration of Recount Results                                    (S.62(4))
EL42       Notice to Candidate of Filing Requirements                        (S.78(6))
EL43       Notice of Default                                                 (S.80(3))
EL46       Ballots Account
EL47       Election Official Application
EL 48      Refund of Nomination Fee
                                                                                                                3
                                                                                              Form EL07
                             LIST OF CERTIFIED CANDIDATES*
                                  Municipal Elections Act, 1996 (s.11(4) 2)

                       NOTICE is hereby given to the Municipal Electors of the

                                     (NAME OF MUNICIPALITY(s))

That during the period commencing on January 4, 2010 and completed on Nomination Day,
September 10, 2010, the following persons filed all necessary papers, declarations and fees and
as Clerk, I am satisfied that such persons are qualified and that their Nominations satisfy the
requirements of the Municipal Elections Act, 1996. I have, therefore, certified such candidates for
the office, which follows their respective name:

NAME OF CANDIDATE                                      OFFICE




                 Dated this ______day of ____________________________, 2010


                                                                _____________________________
                                                                          Municipal Clerk or designate




* This form may be used by the clerk responsible for nominations, to advise clerks in other municipalities
who are responsible for conducting a vote for candidates elected across more than one municipal
jurisdiction. While S.11 deals with police villages, the form may also be used by clerks involved with shared
school trustee positions.
                                                                                                           4

                                                                                             Form EL08
                                                                                  *
                         CERTIFICATE OF ELECTION RESULTS
                                  Municipal Elections Act, 1996 (s.11(4) 3)



I hereby certify that during the municipal election held on Monday, October 25, 2010, for the
offices listed below, the certified candidates received the votes that follow their respective names:

NAME OF CANDIDATE                   OFFICE                              VOTES




                       Dated this _____ day of ____________________, 2010



                                                                    _____________________________
                                                                          Municipal Clerk or designate




* This form may be used to report election results from one municipality to another municipality for
candidates elected across more than one municipal jurisdiction. While Section 11 deals with Police Villages,
this form may also be used by Clerks involved with shared School Trustee positions.
                                                                                                            5

                                                                                             Form EL09
                                                                                     *
                       FINAL SUMMARY OF ELECTION RESULTS
                                  Municipal Elections Act, 1996 (s.11(4) 4)



I hereby certify that during the municipal election held on Monday, October 25, 2010, for the
offices listed below, the certified candidates received the votes that follow their respective names:

NAME OF CANDIDATE                   OFFICE                               VOTES




                   Dated this ______ day of _________________________, 2010




                                                                    _____________________________
                                                                          Municipal Clerk or designate




* This form may be used to report the accumulated election results for candidates elected across more than
one municipal jurisdiction. While Section 11 deals with Police Villages, this form may also be used by Clerks
involved with shared School Trustee positions.
                                                                                                         6

                                                                                          Form EL10

              APPOINTMENT AND OATH OF DEPUTY RETURNING OFFICER*
                                 Municipal Elections Act, 1996 (s.15(1))

Ward No.:                   Voting Subdivision No.:
Municipality:
Name of Person Appointed as Deputy Returning Officer:


The person named above is hereby appointed Deputy Returning Officer (DRO) for the above
Voting Subdivision in this municipality and in addition to the duties and responsibilities of a DRO
as provided in the Municipal Elections Act, 1996, is hereby delegated the following duties and
responsibilities pursuant to the Municipal Elections Act, 1996.
    •   authority to amend the Voters’ List at the Voting Place to add an Elector, remove an
        Elector’s own name and/or correct erroneous information;
    •   authority to require Electors to provide proof of identity;
    •   authority to administer the Oral Oath of Secrecy and the Oral Oath or Affirmation of
        Qualification;
    •   authority to issue a second ballot to an Elector should an Elector return their first ballot as
        a cancelled ballot;
    •   authority to maintain peace and order at the Voting Place by removing anyone who is
        causing a disturbance.

                                                                    _______________________
                                                                           Municipal Clerk or designate

I, the person named above, solemnly swear (or affirm) that I will:

    •   act faithfully in the capacity set out in my appointment and perform all the duties required
        by law without partiality, fear or affection,
    •   maintain and aid in maintaining the secrecy of the voting, and
    •   not interfere nor attempt to interfere with an Elector when she/he is marking her/his ballot,
        obtain or communicate any information as to how an elector is about to vote or has voted,
        or directly or indirectly induce an Elector to show her/his marked ballot to any person.

Declared before me at the (Name of Municipality), in the (name of Upper Tier, if applicable),

this ____ day of ________________, 2010.

_______________________                                       _______________________
City Clerk or designate                                      Deputy Returning Officer




* This form includes some suggested tasks to be delegated to the DRO. It may be amended to reflect the
duties the Clerk wishes to delegate to the DRO.
                                                                                                           7
                                                                                            Form EL11

                   APPOINTMENT AND OATH OF AN ELECTION OFFICIAL*
                                  Municipal Elections Act, 1996 (s.15(2))

Ward No.(if applicable):                   Voting Subdivision No.(one or more as applicable):

Municipality:
Name of Person Appointed as Election Official:


The person named above is hereby appointed an Election Official (Assistant Returning Officer)
for the above Voting Subdivision in this municipality and in addition to the duties and
responsibilities of an Assistant Returning Officer as provided in the Municipal Elections Act, 1996,
is hereby delegated the following duties and responsibilities pursuant to the Municipal Elections
Act, 1996.
    •   authority to assign DROs, Poll Clerks, Election Constables and Revision Officers to their
        various Voting Subdivisions and informing said individuals as to their appointment.
    •   authority to amend the Voters’ List to add an Elector, remove an Elector’s own name
        and/or correct erroneous information;
    •   authority to require a person to furnish proof of identity, qualifications or any other matter.
    •   authority to approve or deny applications for revision to the Voters’ List;
    •   authority to certify Voting Proxy in the absence of the Clerk;
    •   authority to receive election results as they are reported on Election Day.


                                                                     _______________________
                                                                            Municipal Clerk or designate

I, the person named above, solemnly swear (or affirm) that I will:

    •   act faithfully in the capacity of Assistant Returning Officer and perform all the duties
        required by law without partiality, fear or affection,
    •   maintain and aid in maintaining the secrecy of the voting and,
    •   not interfere nor attempt to interfere with an elector when she/he is marking her/his ballot,
        obtain or communicate any information as to how an elector is about to vote or has voted,
        or directly or indirectly induce an elector to show her/his marked ballot to any person.

Declared before me at the (Name of Municipality), in the (Name of Upper Tier, if applicable), this
____ of ________________, 2010

_______________________                               _______________________
City Clerk or designate                                Election Official




* This form includes some suggested tasks to be delegated to the Election Official. It may be amended to
reflect the duties the Clerk wishes to delegate to the Election Official.
                                                                                                                8
                                                                                           Form EL12(A)

                  APPOINTMENT OF SCRUTINEER BY CANDIDATE*
                                        Municipal Elections Act, 1996



     Check here if appointment applies to all Voting Places within the Municipality, or a particular
     Ward as indicated below.

    Check here if appointment applies to all Voting Subdivisions in a specific Voting Place or
     specific Voting Subdivisions as listed below.



TAKE NOTICE that I, ________________ a candidate for the office of __________________
                         (Name of Candidate)                               (office to which election is being sought)


hereby appoint _______________________ to attend at the Voting Place(s) for

Voting Subdivision No.(s) ___________________ Ward No.(s) ________________

in the Municipality of _____________________ to represent me in such Voting Place(s) on

Monday, October 25, 2010 and at the counting of votes under The Municipal Elections Act, 1996.



         _______________________                                        _______________________
                  Date                                                             Signature of Candidate


CONDUCT OF SCRUTINEERS
 1) It is no longer mandatory that scrutineers be 16 years of age or older to work at an election,
    however, ANYONE who is creating a disturbance at a Voting Place will be removed by the
    Deputy Returning Officer (DRO).
 2) Before being admitted to a Voting Place, a person Appointed as scrutineer shall produce
    and show his/her Appointment (the "Scrutineer Form EL12") to the Deputy Returning Officer
    for the Voting Place and take the oral Oath of Secrecy (Form EL12 (B)) from the Deputy
    Returning Officer before being permitted to remain in the Voting Place.
 3) The candidate or his/her scrutineer has the right to place their own seal on the ballot box
    immediately before the opening of the voting place so that ballots can be deposited in the
    box but cannot be withdrawn without breaking the seal; and immediately after the close of
    each of the Advance Vote days and Election Day so that ballots cannot be deposited or
    withdrawn without breaking the seal. The seal MUST NOT contain any writing that could be
    considered “election campaigning”, therefore, the name of the candidate IS NOT permitted
    on the seal.
      HOWEVER, if a candidate or scrutineer should include their seal on a ballot box, please
      note that Section 55(5) of the Municipal Elections Act, 1996, states:
      “Despite subsection 88(6) (records), the Clerk may, if he or she considers it necessary in
      order to interpret the statement of results, examine any of the documents and materials in a
      ballot box in the presence of the relevant Deputy Returning Officer.”
      In other words, if the Deputy Returning Officer Statement of Election Results is NOT

* Amend this form to reflect the Conduct of Scrutineers for alternative voting methods being used in your
municipality.
                                                                                                9
    complete or contains an error, the ballot box will be opened in the presence of the Clerk and
    the Deputy Returning Officer in order to resolve the discrepancy. It is NOT a requirement
    that candidates and/or scrutineers be notified or present when this takes place.

4) The Deputy Returning Officer is responsible for the conduct of the Voting Place and no
   candidate or scrutineer has the right to interfere with the Deputy Returning Officer in the
   discharge of his or her duties.
5) During the fifteen minutes before the opening of the Voting Place, the candidate or
   scrutineers who are entitled to be present in a Voting Place during voting hours, are entitled
   to visually inspect the ballots and all other papers, forms and documents, but not so as to
   delay the timely opening of the Voting Place. Scrutineers/candidates are permitted to listen
   to discussions between the DRO/Voting Place Clerk and the Elector but they are NOT
   permitted to observe how an Elector votes. Scrutineers/candidates are NOT allowed to
   speak to Electors, touch the ballots or interfere with the voting process. They are simply
   there to observe.
6) Only one scrutineer per candidate is allowed at any given time at each Voting Subdivision.
   The candidate and his or her scrutineer ARE NOT permitted to be present at the Voting
   Subdivision at the same time. If a candidate or scrutineer wishes to have a discussion with
   another scrutineer or candidate, they must leave the Voting Subdivision and carry on their
   discussion outside of the Voting Place. Please note that there is a difference between a
   Voting Subdivision and a Voting Place. Some Voting Places may have more than one
   Voting Subdivision. Obviously, at these locations, a candidate is permitted to have the same
   number of scrutineers as Voting Subdivisions.
7) No campaign material or literature of any nature whatsoever shall be displayed within the
   Voting Place. The boundaries of the Voting Place are the boundaries of the property where
   the Voting Place is located and includes the parking lot. Candidates, supporters and
   scrutineers are NOT permitted to wear campaign material, hand out campaign material, or
   park a vehicle displaying campaign material in the parking lot of the Voting Place. Anyone
   breaking these rules will be asked to remove the campaign material immediately.
8) Scrutineers are reminded to provide a clipboard for their use, as sitting at the table, which is
   provided for the Deputy Returning Officer and Voting Place Clerk, IS NOT permitted.
9) Scrutineers/candidates may examine the Voters’ List periodically to determine who has
   voted or to count how many Electors have voted. However, this periodic examination should
   not slow down the voting process.
10) Scrutineers/candidates wishing to observe the count MUST be at the Voting Place prior to
    8:00 p.m. No one will be admitted to the Voting Place after 8:00 p.m.
11) After the close of the Voting Place and during the counting of the votes, scrutineers may
    examine all ballots but SHALL NOT handle them. Scrutineers may object to the counting of
    a ballot and any objection will be noted on the back of a ballot. The final decision as to
    whether a vote should be counted is the sole responsibility of the Deputy Returning Officer.
    Scrutineers/candidates shall not, in any way, impede the progress of the counting of the
    votes.
12) The total of votes cast for each candidate as counted by the Deputy Returning Officer and
    Voting Place Clerk is final. They are not required to do a recount/ second count.
                                                                                                   10
                                                                                Form EL12 (B)

                                ORAL OATH OF SECRECY




I, _______________________________, do solemnly swear (or affirm):
        (state name)

       That I will maintain and aid in maintaining the secrecy of the voting; and

       That I will not, nor attempt to:

       •   interfere with an elector when he/she is marking his/her ballot;

       •   obtain or communicate any information as to how an elector is about to vote or has
           voted; or

       •   directly or indirectly induce an elector to show his/her marked ballot to any person.




           TO BE DECLARED BY ANY SCRUTINEER OR CANDIDATE WISHING
                       TO REMAIN AT THE VOTING PLACE
                                                                                                 11

                                                                                   Form EL14

                CANDIDATE'S DECLARATION- PROPER USE OF VOTERS'
                                LIST
                          Municipal Elections Act, 1996 (s.23(4); 88(10))



      I, ____________________________, being a candidate for the office of

     ____________________________________, hereby request the Clerk to
       provide me with the following information when it becomes available:

              a paper copy of the Voters’ List (on or before Wednesday, September 1, 2010.
              Please note that a copy of all revisions made to the Voters’ List will be provided
              on or before Monday, September 20, 2010.
OR
              an electronic copy of the Voters’ List (on or before Wednesday, September 1,
              2010). Please note that a copy of all revisions made to the Voters' List will be
              provided on or before Monday, September 20, 2010.

AND
              a copy of the Lists showing the name of each person who has voted at each
              Advance Vote.



I, the undersigned, do hereby agree to use the Voters’ List for election
purposes only and I understand that I am prohibited by the Municipal
Elections Act, 1996 from using the Voters’ List for commercial purposes.




__________________________________                                 ____________________
     Signature:                                                               Date


Name: __________________________________
         (please print)
       12
Form EL15
                                                                                                    13
                                                                                      Form EL16
                                                                                 (Prepare in triplicate)

APPLICATION FOR REMOVAL OF ANOTHER’S NAME FROM VOTERS’ LIST
                                  Municipal Elections Act, 1996 (s. 25)

Municipality



Surname of Applicant                                   Given Names


Full Address of Residence                          Apt #                        Postal Code



IN RESPECT OF
Name as Entered in Voters' List


Full Address of Residence                          Apt #                        Postal Code



ENTERED ON LIST FOR
Ward No. (if any)   Voting Subdivision No. (if                Assessment Roll Number (to be
                    any)                                      completed by Clerk or designated
                                                              election official)




                               STATEMENT BY APPLICANT
I, the undersigned, hereby state:

That I have good reason to believe that the person named above as entered on the Voters’ List
for the said voting subdivision in this municipality is not entitled to be an elector and to have
her/his name entered thereon; and;

That I will personally or by a representative attend a hearing to be held by the Clerk or designate
and there establish the validity of my application, the facts in support of which are as follows:




___________________________                                           ____________________
(signature of applicant)                                                      (date signed)
                                                                                               14

                                                  Form EL16
APPLICATION FOR REMOVAL OF ANOTHER’S NAME FROM VOTERS’ LIST
                         (CONT'D)



NOTICE OF HEARING*
TAKE NOTICE that the above application has been filed with me under the authority of section 25
of the Municipal Elections Act, 1996 alleging that the above named elector has been wrongfully
included on the Voters' List prepared for the said voting subdivision in this municipality. Such
name may be removed from the Voters' List if you or your representative do not appear at the
hearing, to be held as set out below, to oppose this application and to substantiate your right to
have your name remain on the list.

Hearing to be held:
                                                       __________________________________
                                                            Municipal Clerk or designate
Date ______________ Time ____________

Place _______________________________________         ________________________
                                                              (date of notice)
Address _______________________________________________

Note: A hearing is not required to delete the
name of a deceased person
                                                             _____________________________
                                                                              (telephone no.)




OUTCOME OF HEARING: This application is            approved     or      refused

(Clerk shall note reasons for decision).




_________________                                               _______________________
   Date                                                         Municipal Clerk or designate




* See Sec 25 (3)-(9) For Notice Provisions
                                                                                                          15
                                                                                                   Form EL17

                               NOTICE OF NOMINATION FOR OFFICE
                                  Municipal Elections Act, 1996 (s.32)

            NOTICE is hereby given to the Municipal Electors of the Municipality of Brockton

                                            Brockton Council
                                         Mayor – elected at-large
                                    Deputy Mayor – elected at-large
                               Councillors – 5 positions – all elected at-large

                                     Bluewater District School Board
         1 Trustee to be elected by the electors in the Municipalities of Brockton and South Bruce

                                    Bruce-Grey Catholic School Board
1 Trustee to be elected by the electors in the Brant ward and Walkerton ward of Brockton;

Nominations for the above referenced offices may be made by completing and filing in the office of the
Municipality of Brockton, nominations on the prescribed forms and accompanied by the prescribed
nomination filing fee: (Mayor - $200.00; Deputy Mayor, Councilors or Trustees - $100.00). The filing fee
is payable by cash, debit, certified cheque or money order.

A nomination must be signed by the candidate and may be filed in person or by an agent during regular
business hours of 8:30 a.m. – 4:30 p.m. Monday to Friday and between 9:00 a.m. – 2:00 p.m. on Friday,
September 10th, 2010 (Nomination Day).

                                    Bruce-Grey Catholic School Board
1 Trustee to be elected by the electors in the Greenock ward of Brockton, the electors in the Municipality
of Huron-Kinloss and the electors in the Municipality of Kincardine.

Nominations for the above referenced office may be made by completing and filing in the Municipality of
Kincardine nominations on the prescribed form and accompanied by the prescribed nomination filing fee
of $100.00. The filing fee is payable by cash, certified cheque or money order.

In the event there are an insufficient number of certified candidates to fill all positions available,
nominations will be re-opened only for the vacant positions on Wednesday, September 15th, 2010 between
the hours of 9:00 a.m. – 2:00 p.m. and such additional nominations, if required, may be filed in the
Municipality of Brockton Office.

Electors are hereby given notice that if a greater number of candidates are certified than are required to fill
the said offices, voting places will be opened on the dates stated below for the purpose of voting.

BROCKTON ADVANCE VOTE: by telephone or internet only 8:30 a.m. Monday, October 18, 2010
until 8:00 p.m. Monday, October 25, 2010. (There will not be a paper ballot advance poll)

VOTING DAY: Monday, October 25th, 2010– 10:00 a.m. – 8:00 p.m. Electors may vote in person at
Brockton Municipal Office, Cargill Public Library and former Brant Township Council Chambers.

Dated this 12th day of July, 2010

Debra B. Roth, Clerk
Municipality of Brockton
100 Scott Street, WALKERTON, Ontario          N0G 2V0
Phone: (519) 881-2223
                                                                                         16

                                                                             Forrm EL18(A)


                      DECLARATION OF QUALIFICATIONS – COUNCIL
                                             Municipal Elections Act, 1996

                  DECLARATION OF QUALIFICATIONS
     FOR THE MUNICIPALITY OF BROCKTON 2010 MUNICIPAL ELECTION
                      MUNICIPAL CANDIDATES

I, ____________________________________, a nominated candidate for the office of :

         € Mayor
         € Deputy Mayor
         € Councillor

Do solemnly declare that:

1. I am qualified pursuant to the Municipal Elections Act, 1996 and the Municipal Act,
   2001 to be elected to and to hold the office of:

         € Mayor
         € Deputy Mayor
         € Councillor

2. Without limiting the generality of paragraph 1, I am at least eighteen years of age, a
   Canadian citizen, a resident of the Municipality of Brockton or the owner or tenant of
   land in the Municipality of Brockton or the spouse or same sex partner of such owner
   or tenant.

3. I am not ineligible or disqualified under the Municipal Elections Act, 1996, the
   Municipal Act, 2001 the Municipal Conflict of Interest Act or any other Act to be
   elected to or hold the above-mentioned office.

4.       Without limiting the generality of paragraph 3,

     •    I am not an employee of the Municipality of Brockton, or if I am an employee of
          the Municipality of Brockton, I am on an unpaid leave of absence as provided for
          by section 30 of the Municipal Elections Act, 1996.

     •    I am not a judge of any court.

     •    I am not a member of the Assembly as provided in the Legislative Assembly Act or
          of the Senate or House of Commons of Canada or, if I am such a person, I will
          provide proof of my resignation in a form satisfactory to the Clerk of the
          Municipality of Brockton prior to 5:00 p.m. on Nomination Day, September 10,
                                                                                                                                         17
              2010. I understand that the Clerk of the Municipality of Brockton will reject my
              nomination for the above-mentioned office if I fail to provide proof of resignation
              by this deadline.
         •    I am not a member of the Executive Council of Ontario or a federal
               Minister of the Crown.

         •    I am not a Crown employee within the meaning of the Public Service Act, or if I am
              a Crown employee, I have followed and will continue to follow all the relevant
              provisions of Part II of such Act.

    5. I am not prohibited from voting at the municipal election under subsection 17(3) of
       the Municipal Elections Act, 1996.

    6. Without limiting the generality of paragraph 5,

         •     I am not a person who is serving a sentence of imprisonment in a penal or
             correctional      institution.

         •     I am not a person who was convicted of a corrupt practice described in subsection
             90(3) of the Municipal Elections Act, 1996 during an election that occurred less than
             four years prior to Monday, October 25, 2010.

    7. I am not a candidate who was convicted of a corrupt practice under the Municipal
       Elections Act, 1996 or of an offence under the Criminal Code (Canada), in connection
       with an act or omission with respect to a municipal election if the Voting Day in that
       election is less than six years prior to Monday October 25, 2010.

    8.        I am not disqualified from being elected to or holding office by reason of any
             violations of       the election campaign financial requirements or violations for not
             filing the financial statement pursuant to the Municipal Elections Act, 1996.

AND I make this solemn Declaration conscientiously believing it to be true, and knowing
that it is of the same force and effect as if made under oath and by virtue of the Canada
Evidence Act.

Declared before me at the Municipality of Brockton


This_____day of _________________, 2010
                                                                                    ________________________
                                                                                    (Signature of candidate)

________________________________
(Signature of Clerk or designate)


Personal information on this form is collected under the authority of the Municipal Elections Act, 1996 and will be used for the nomination
process for office in the municipal election and will be available for public inspection in the office of the Clerk, Municipality of Brockton
until the next municipal election. Questions about this collection of personal information should be directed to Debra Roth, Clerk.
                                                                                        18
                                                                          Form EL18(B)

                   DECLARATION OF QUALIFICATIONS – SCHOOL
                                  TRUSTEE
                                Municipal Elections Act, 1996

               DECLARATION OF QUALIFICATIONS
  FOR THE MUNICIPALITY OF BROCKTON 2010 MUNICIPAL ELECTION
                 SCHOOL BOARD CANDIDATES


I, ____________________________________, a nominated candidate for the office of
Trustee, for the :

   € Bluewater District School Board
   € Bruce-Grey Catholic District School Board

Do solemnly declare that:

8. I am qualified pursuant to the Municipal Elections Act, 1996 and the Education Act to
   be elected to and to hold the office of Trustee, for the above noted School Board

9. Without limiting the generality of paragraph 1, I am a resident of the area of
   jurisdiction of the School Board, a Canadian citizen and at least eighteen years of age.

10. I am qualified under the Education Act to vote for members of the School Board to
    which I am seeking office.

11. I am not ineligible or disqualified under the Municipal elections Act, 1996, the
    Education Act, the Municipal Conflict of Interest Act or any other Act to be elected to
    or hold the above-mentioned office.

12. Without limiting the generality of paragraph 4,

   •   I am not an employee of the School Board or if I am an employee of the School
       Board, I
       am on an unpaid leave of absence as provided for by section 219 of the Education
       Act          and section 30 of the Municipal Elections Act, 1996.

   •   I am not a clerk or treasurer or deputy-clerk or deputy treasurer of any
       municipality within the area of jurisdiction of the School Board or if I am such a
       person, I am on an unpaid leave of absence as provided for by section 219 of the
       Education Act and section 30 of the Municipal Elections Act, 1996.

   •   I am not a member of the Assembly as provided in the Legislative Assembly Act
       or of the Senate or House of Commons of Canada or, if I am such a person, I will
       provide proof of my resignation in a form satisfactory to the Clerk of the
       Municipality of Brockton, prior to 5:00 p.m. on Nomination Day, September 10,
                                                                                                                                         19
               2010. I understand that the Clerk of the Municipality of Brockton will reject my
               nomination for the above-mentioned office if I fail to provide proof of resignation
               by this deadline.

           • I am not a member of the Executive Council of Ontario of a federal Minister of
             the Crown.


    13. I am not prohibited from voting at the municipal election under subsection 17(3) of
        the Municipal Elections Act, 1996.

    14. Without limiting the generality of paragraph 6,

               o I am not a person who is serving a sentence of imprisonment in a penal or
                 correctional institution.

           • I am not a person who was convicted of a corrupt practice described in subsection
             90(3) of the Municipal Elections Act, 1996 , during an election that occurred less
             than four years prior to Monday October 25, 2010.

    15. I am not a candidate who was convicted of a corrupt practice under the Municipal
        Elections Act, 1996 or of an offence under the Criminal Code (Canada), in connection
        with an act or omission with respect to a municipal election if the Voting Day in that
        election is less than six years prior to Monday October 25, 2010.

    16. I am not disqualified from being elected to or holding office by reason of any
        violations of the election campaign financial requirements or violations for not filing
        the financial statement pursuant to the Municipal Elections Act, 1996.

    AND I make this solemn Declaration conscientiously believing it to be true, and knowing
    that it is of the same force and effect as if made under oath and by virtue of the Canada
    Evidence Act.

    Declared before me at the Municipality of Brockton

    This ______ day of _____________________, 2010
                                                  ___________________________
                                                  (Signature of candidate)


    _______________________________
    (Signature of Clerk or designate)
Personal information on this form is collected under the authority of the Municipal Elections Act, 1996 and will be used for the nomination
process for office in the municipal election and will be available for public inspection in the office of the Clerk, Municipality of Brockton
until the next municipal election. Questions about this collection of personal information should be directed to Debra Roth, Clerk.
                                                                                                         20
                                                                                            Form EL19

                             WITHDRAWAL OF NOMINATION*†
                                    Municipal Elections Act, 1996 (s.36)




I, ________________________________, hereby withdraw my name as a candidate
            (Name of Candidate)

for the office of_____________________________________.
                         (Name of Elected Office)




_______________________                               _________________________
     Date                                                     Signature of Candidate




THIS WITHDRAWAL DELIVERED TO ME AT ____________
                                                                      (time)

THIS____________ DAY OF _____________________________, 2010.


                                        _________________________________________
                                                Municipal Clerk or designate




* A person who has been nominated may withdraw his or her nomination by filing a written withdrawal in the
Clerk's office by 2 p.m. on Nomination Day (September 10, 2010) if the nomination was filed on or before
                                                 th
Nomination Day and by 2 p.m. on September 15 , if the nomination was filed under subsection 33(5).
† Clerk may want to require a candidate to appear in person, with identification in order to withdraw their
nomination. If not, then anytime that a nomination withdrawal is submitted by someone other than the
nominee, the Clerk should follow up to ensure that the withdrawal was submitted with the nominee's
permission.
                                                                                                    21
                                                                                       Form EL20

                   DECLARATION OF ACCLAMATION TO OFFICE
                                Municipal Elections Act, 1996 (s. 37(1))



I hereby declare the certified candidates listed below to be acclaimed to the office that follows
their respective names pursuant to Section 37 of the Municipal Elections Act, 1996:


NAME OF CERTIFIED CANDIDATE                                           OFFICE




        Dated this ______day of ____________________, 2010




                                                                 _____________________________
                                                                       Municipal Clerk or designate
                                                                                                22
                                                                                    Form EL21

                NOTICE OF DEATH/INELIGIBILITYOF CANDIDATE
                           Municipal Elections Act, 1996 (s.39 (a) and (b))




Notice is hereby given that____________________________________ a candidate
                                   (name of candidate)

for the office of ____________________________________has died/become ineligible to hold
the office



Since no other candidate would be elected by acclamation as a result of the
death/ineligibility, the election for this office shall proceed as if the deceased/ineligible
candidate had not been nominated.



or


Since, as a result of the death/ineligibility, another candidate would be elected by
acclamation to office, the election for the above office is void and a by-election shall be
held.




Dated this ________day of __________________, 2010.




                                                                _____________________________
                                                                      Municipal Clerk or designate
                                                                                                          23
                                                                                             Form EL22

                           CERTIFICATE OF THE VOTERS' LIST*
                                  Municipal Elections Act, 1996 (s. 28 (1))



I hereby certify that the attached Voters' List contains the names of persons entitled to vote at the
Municipal Elections to be held on Monday, October 25, 2010, for the voting subdivision(s) set out
below:



Municipality


Ward No (if applicable)                      Voting Subdivision No(s) (if applicable)




Dated this ______day of _________________, 2010.




                                                                    _____________________________
                                                                          Municipal Clerk or designate




* The Voters' List for use in the Voting Subdivision should be prepared as late as possible so that as many
revisions made to the List as possible can be included. Clerks may choose to create this List from a
computer database.
                                                                                                                             24
                                                                                                           EL2010 –FOI

                                  FREEDOM OF INFORMATION (FOI) RELEASE
            MUNICIPALITY OF BROCKTON - 2010 MUNICIPAL
                          ELECTION



I, __________________________________, candidate for the office of:

Mayor                           □
Deputy Mayor                    □
Councillor                      □
School Board                    □

In accordance with the Municipal Freedom of Information and Protection of Privacy Act, as
amended, I hereby authorize that the following information with respect to my candidacy for
elected office may be published on the Municipality of Brockton website and made available upon
request to any member of the press or public.

                                           Contact Information
Mailing Address:                          ______________________________

                                          ______________________________

                                          ______________________________

Telephone Number (home):                  ______________________________

Telephone Number (work):                  ______________________________

Fax number:                               ______________________________

E-mail Address:                           ______________________________




____________________________
Signature of Nominated Candidate




Dated this ________ day of ______________, 2010



Personal information on this form is collected under the authority of the Municipal Elections Act, 1996 and will be used for the
nomination process for office in the municipal election and will be available for public inspection in the Office of the Clerk, Municipality
of Brockton until the next municipal election.
                                                                                                         25
                                                                                            Form EL24

  SAMPLE NOTICE OF ELECTION INFORMATION (FOR NEWSPAPER AD)
                                     Municipal Elections Act, 1996 (s.40)


                 Municipal Elections in the (Name of Municipality) for the offices of:

                            (LIST OF MUNICIPAL POSITIONS)
                        (LIST OF POSITIONS ON LOCAL BOARDS)
        (LIST OF SCHOOL BOARD POSITIONS SHARED WITH OTHER MUNICIPALITIES)
                                                      th
                             will be held on the 25 day of October, 2010


    •    location of voting places

    •    dates and times on which voting places will be open

    •    dates and times for advance voting
                                                               *
    •    manner in which electors may use voting proxies

    •    additional information as appropriate to the circumstance




___________________                                             _____________________________
(date)                                                           Municipal Clerk or designate




* If alternative voting methods are used, these may eliminate the requirement for voting proxies. If so, the
notice above needs to include information and directions on the manner of alternative voting and the section
on voting proxies needs to be eliminated or amended accordingly. Clerks may choose to continue to provide
a mailed notice addressed to electors. If a householder mailing is used, consider the need to advertise to
give notice to non-resident electors. See Form EL45 (A)
                                                                                                    26
                                                                                   Form EL25(A)
                                                                                   Prepare in duplicate


                     CERTIFICATE AND RECEIPT FOR BALLOTS
                                Municipal Elections Act, 1996 (s.41(1))




Ward No.(if applicable)                             Voting Subdivision No.(if applicable)

Municipality

                                 List of Ballots by type and quantity
        BALLOT TYPE                           QUANTITY                    CORRECTED QUANTITY
                                        (as delivered by Clerk)             (as verified by DRO)




I, the undersigned Clerk (or designated election official) of this Municipality, do hereby declare
that I have supplied to the Deputy Returning Officer of the said voting subdivision, the types and
quantities of ballots as listed above.


                                                       ____________________________________
                                                                    Municipal Clerk or designate

I, the undersigned Deputy Returning Officer for the said voting subdivision, do hereby declare that
I received from the Clerk of this municipality, the types and quantities of ballots as delivered to me
or, if different, as verified by me.


                                                       ____________________________________
                                                                       Deputy Returning Officer


Composite ballots count as one type. Single ballots count as one type and could be differentiated
by the office for which they are prepared. The quantity (or corrected quantity) is the total to which
ballot accounts on Voting Day will be made. This form should be prepared in duplicate with the
Clerk retaining the original and the DRO's copy placed in the Ballot Box at the end of the Vote
Count and returned with other materials to the Clerk.
                                                                                                       27



                                                                                           Form EL26
                                                                   *
                                      OATH OF QUALIFICATION
                                Municipal Elections Act, 1996 (s.52 (1) 3)


I am the person named or intended to be named on the voters’ list or document shown to me; and
I have not before voted at the election now being held in the (Name of Municipality). I am a
Canadian citizen, at least 18 years of age and a resident of the (Name of Municipality) or a non-
resident owner or tenant of land in the (Name of Municipality), or the spouse of such owner or
tenant.

NAME (please print)                                   SIGNATURE




* This form to be used for electors who have been objected to under paragraphs 2 and 3 of subsection 52(1)
of the MEA.
                                                                                                      28
                                                                                          Form EL27

                      ORAL OATH OF FRIEND OR INTERPRETER
                                      Municipal Elections Act, 1996



           ORAL OATH OF FRIEND /SUPPORT PERSON OF ELECTOR

I, (name of friend), a friend of (name of elector), an elector who is unable to vote without
assistance, and who is entitled to vote in this municipality declare that I will:

    •   mark the ballot as directed by the elector; and

    •   keep secret the manner in which this elector voted.


                              ORAL OATH OF INTERPRETER

I, (name of interpreter) acting as interpreter for (name of elector), an elector entitled to vote in this
municipality, declare that I will faithfully translate the necessary oaths as well as any lawful
questions necessarily put to the elector and his/her answers at this voting place.
                                                                                                              29
                                                                                                 Form EL27(A)

  OATH OF ELECTOR REQUESTING ASSISTANCE
               OF A FRIEND
                                        Municipality of Brockton
                                        2010 Municipal Election




I, _________________________________________________, being an
 (PLEASE PRINT: name of the elector as it appears or is intended to appear on the Voter’s List or document)



elector entitled to vote in the municipality swear or solemnly affirm:

         That I am uncomfortable voting without assistance and I require
         assistance of a friend (or Election Official) to vote by telephone/internet.




_______________________________                                     _________________
Signature of Applicant                                                        Date




SWORN OR AFFIRMED before me
at the Municipality of Brockton in the
County of Bruce this _________ day
of ___________________, 2010.

_______________________________________________
Signature of Commissioner of Oath
                                                                                                            30
                                                                                           Form EL29(A)

                     VOTING INSTRUCTIONS (Manual Count Ballot)*
                                 Municipal Elections Act, 1996 (s.52(3), (4))



                  ELECTORS PLEASE FOLLOW THESE
                         4 STEPS TO VOTE

    1. MARK THE BALLOT -                               make a cross (X) or other mark in the
                                                       space after the name of the candidate
                                                       for whom you are voting.


    2. FOLD THE BALLOT -                               the ballot should be folded so that the
                                                       front of the ballot does not show.


    3. RETURN THE FOLDED BALLOT to the Deputy Returning Officer.


    4. WATCH THE DEPUTY RETURNING OFFICER place your ballot into
       the ballot box.




* This notice should be posted in the voting place and in the voting booth. If alternative voting equipment is
used, the notice may need to be amended accordingly.
                                                                                                           31

                                                                                              Form EL30

             LIST OF OBJECTIONS TO VOTE COUNT (Manual Count)*
                                   Municipal Elections Act, 1996 (s.54(4))

Following is a list of the ballots that were objected to, in whole or in part, by a scrutineer or
certified candidate, and a summary of the objections to the vote or ballot.

D.R.O. to place the corresponding number on the back of the ballot objected to together with
D.R.O.’s initials.
1.                                              11.

2.                                                      12.

3.                                                      13.

4.                                                      14.

5.                                                      15.

6.                                                      16.

7.                                                      17.

8.                                                      18.

9.                                                      19.

10.                                                     20.




* This form is to be completed by D.R.O., placed in the ballot box and sealed with the ballots along with the
other material and documents related to the election.
                                                                                                                                    32




                                                                                                              Form EL31(A)

                        DEPUTY RETURNING OFFICER
               STATEMENT OF ELECTION RESULTS (MANUAL COUNT)
                                   Municipal Elections Act, 1996 (s.55(1) a)
 (NAME OF MUNICIPALITY)                                            WARD NO._________

Black                      Colour
Office of the Mayor       Office – Councillor Ward                                     Mun.             Public     Public   Sep.    Sep.
Candidate’s Number        Candidate’s Number                                           Office           (eng)      (Fr)     (Eng)   (Fr)
Name           of Votes   Name           of Votes                                      (black)          Yellow     Blue     Green   Pink
                                                            Total Number of
                                                            Ballots received
                                                            from the Clerk
                                                            A) Other Ballots (Count these ballots BEFORE opening the ballot box)
                                                            Cancelled Ballots
                                                            Forfeited
                                                            Declined
                                                            B) Unused Ballots
                                                            C) Used Ballots (Count these ballots upon opening the ballot box)
                                                            Used Ballots
                                                            (Counted in whole
                                                            or in part)
Colour                     Colour                           Totally Rejected
Member – Public School    Member – Public School            Ballots
(Eng)                     (Fr)                              Used but totally
Candidate’s Number        Candidate’s Number                unmarked
Name         of Votes     Name         of Votes             TOTAL of A B
                                                            and C
                                                            (Total should equal
                                                            number of ballots
                                                            received from the
                                                            clerk)
                                                            Dated this              day of October, 2010

                                                            We, the appointed DRO and the appointed Voting Place Clerk for
                                                            the said Voting subdivision in this municipality do declare:
                                                            A) THAT we have performed all the duties and processed and
                                                                completed all the documents as required of us by law
                                                            B) THAT to the best of our knowledge and belief, the voting list
Colour                     Colour                               for this voting subdivision has been kept correctly and
Member – Separate         Member – Separate                     contains a true and exact record of the electors who voted,
School (Eng)              School (Fr)                           and
Candidate’s Number        Candidate’s Number                C) THAT the number of votes recorded in this statement is
Name         of Votes     Name        of Votes                  correct.

                                                            Deputy Returning Officer               Voting Place Clerk


                                                            Signature of Scrutineer (if present)


                                                            Signature of Scrutineer (if present)

                                                            Signature of Scrutineer (if present)

                                                            The Original Statement of the DRO is to be placed in the colour
                                                            envelope marked ‘XXX’ and delivered to the Clerk after the close
Total Number of Electors who voted at this
                                                            of voting when the ballot box is returned. It is NOT placed in the
voting subdivision:                                         ballot box
                                                                   S
                                                            The duplicate (colour) copy of this statement is to be placed in the
                                                                   U
                                                                   box.
                                                            ballot B
                                                                                                        33




                                                                                           Form EL32
                       DECLARATION OF ELECTION CANDIDATE*
                                 Municipal Elections Act, 1996 (s. 55(4) a)

I, _________________________________, Clerk (or designated election official)
(name of Clerk or designate)

of the Corporation of the _____________ of _________________________

in the ________________ of ____________________________

                            declare the following candidate or candidates
                 elected as a result of the Municipal Election held October 25, 2010


NAME OF GOVERNMENT BODY                  (Council, School Board, etc.)

         OFFICE                                             ELECTED CANDIDATE

1. _________________________                        ________________________________

2. _________________________                        ________________________________

3. _________________________                        ________________________________

4. _________________________                        ________________________________

5. _________________________                        ________________________________

6. _________________________                        ________________________________

7. _________________________                        ________________________________


         ____________________                                           _______________________
         Date                                                           Municipal Clerk or designate




* The Clerk shall as soon as possible after Voting Day declare the candidate or candidates who received the
highest number of votes to be elected (s.55(4) a)
                                                                                         34


                                                                              Form EL34

       STATUTORY PROVISIONS REGULATING VOTING PROCEDURES*
                                   Municipal Elections Act, 1996 (s.48, 49)

Prohibition       48(1) While an elector is in a voting place, no person shall attempt,
                        directly or indirectly, to influence how the elector votes.

No Election          (2) Without limiting the generality of subsection (1), no person
campaign                 shall display a candidate's election campaign material or
material                 literature in a voting place.

Secrecy           49(1) Every person who is present in a voting place or at the
                        counting of the votes shall help to maintain the secrecy of
                        the voting.

Offences              (2) No person shall,
                       (a) interfere or attempt to interfere with an elector who is
                           marking the ballot;
                       (b) obtain or attempt to obtain, at a voting place, information
                           about how an elector intends to vote or has voted; or
                       (c) communicate any information obtained at a voting place
                           about how an elector intends to vote or has voted.

Same               (3)     No elector shall show his or her marked ballot to any person
                           so as to reveal how he or she has voted, except in
                           connection with obtaining assistance in voting under
                           paragraph 4 of subsection 52(1).

No requirement (4) No person shall, in a legal proceeding relating to an election,
disclosure         be required to disclose how he or she voted at the election.




* The Clerk may post copies of this notice in the voting place
                                                                                                   35

                                                                                       Form EL35

             NOTICE OF OFFENCE NOTICE OF CORRUPT PRACTICE*
                                    Municipal Elections Act, 1996 (s. 89)

Section 89 of the Municipal Elections Act, 1996 provides that a person is guilty of an offence, if he
or she,

    (a)      votes without being entitled to do so;
    (b)      votes more times than the Act allows;
    (c)      votes in a voting place in which he or she is not entitled to vote;
    (d)      induces or procures a person to vote when that person is not entitled to do so;
    (e)      having appointed a voting proxy that remains in force, votes otherwise than by the
             proxy;
    (f)      having been appointed a voting proxy, votes under the authority of the proxy when
             the elector has cancelled the proxy, is no longer entitled to vote, or has died;
    (g)      before or during an election, publishes a false statement of a candidate's withdrawal;
    (h)      furnishes false or misleading information to a person whom this Act authorizes to
             obtain information;
    (i)      without authority, supplies a ballot to anyone;
    (j)      delivers to the deputy returning officer to be placed in a ballot box a paper other than
             the ballot the deputy returning officer gave him or her;
    (k)      takes a ballot away from the voting place;
    (l)      at an election, takes, opens or otherwise deals with a ballot, a ballot box, or a book or
             package of ballots without having the authority to do so;
    (m)      attempts to do something described in clauses (a) to (l)

Section 90 of the said Act provides that if, when a person is convicted of an offence under
Section 89, the presiding judge finds that the offence was committed knowingly, the offence also
constitutes a corrupt practice.




* The Clerk may choose to post this notice in the voting place.
                                                                                                        36

                                                                                          Form EL36
                                                                                     (prepare in triplicate)


                            DISCLAIMER TO RIGHT TO OFFICE
                               Municipal Elections Act, 1996 (s. 84 (1) - (3))



I, ___________________________________, hereby disclaim all right to the office of
(Name of Elected Candidate)

_____________________________________ to which I was elected in the Municipal
(Name of Elected Office)

Election of October 25, 2010.


_______________________                               ____________________________________
     Date                                                     Signature of Candidate




             THIS DISCLAIMER DELIVERED TO ME AT _____________(time) THIS

                  ___________ DAY OF _________________________, 2010.


                                             _________________________________________
                                               Municipal Clerk or designate




NOTE: A person who has been elected may disclaim all right to the office within 90 days after
Voting Day unless an application is made under s. 83(1)(b) questioning his or her election (s.
84(1)). The disclaimer shall be in writing and addressed to the Clerk who conducted the election
(s. 84(2)).

A person whose election is questioned in an application under s. 83(1)(b) may, within seven days
after being served with the application, disclaim all right to the office (s. 84(3)). The disclaimer
shall be made and delivered in accordance with section 84(4).

ALSO NOTE: Clerk may want to require the elected official to appear in person, with
identification, in order to disclaim rights to an office. If not, anytime that a disclaimer is submitted
by someone other than the elected official, the Clerk should follow up to ensure that the
disclaimer was submitted with the elected official’s permission.
                                                                                                 37

                                                                                      Form EL37

                 CERTIFICATE OF MAXIMUM CAMPAIGN EXPENSES
                                   Municipal Elections Act, 1996 (s. 76 (7))

TO:

________________________________________                      /   ______________________________
    (Name of Candidate)                                                  (Office)

_____________________________________________________________________________
    (Address)                                                (Postal Code)


FROM:

The Clerk, or designated election official, of
___________________________________________________________________________
                                   (Name of Municipality)



I hereby certify that the maximum campaign expenses that a candidate is permitted to incur for

the office of ____________________________________ in the Municipal Election to be held
                                                          *
October 25, 2010, is ________________________
.

_____________________                         _______________________________________
      Date                                                 Municipal Clerk or designate


The Clerk shall give candidates a preliminary calculation of the maximum campaign expenses at
the time of filing the nomination paper, based upon the number of electors on the Voters' List as
of Nomination Day for the 2006 election.

Within 10 days after Nomination Day, the Clerk shall give a "final" certificate of the applicable
maximum campaign expenses to each candidate. The number of electors to be used in this final
calculation is to be the greater of the number of electors from the 2006 or 2010 elections. (s.76)

Certificate to be given to candidate in accordance with Section 13.




* Formula for calculation provided in Section 76(4).
                                                                                                            38

                                                                                               Form EL38

          WITNESS STATEMENTS AS TO DESTRUCTION OF BALLOTS*
                                   Municipal Elections Act, 1996 (s.88(2))

_____________________________________ in the ___________ of _____________________
(Name of Municipality)                       (Name of County, District or Region)


FIRST WITNESS

I ________________________ state that I was present upon _______________ and did witness
        (Name of Witness)                                            (date)
____________________________ of the above stated municipality destroy all ballots used in the
    (Name of Clerk or designate)

municipal election held on October 25, 2010 for the election of persons to the offices listed below.
                                               _______________________________________
                                                          (Signature of Witness)




SECOND WITNESS

I ______________________ state that I was present upon _______________ and did witness
       (Name of Witness)                                            (date)
____________________________ of the above stated municipality destroy all ballots used in the
   (Name of Clerk or designate)

municipal election held on October 25, 2010 for the election of persons to the offices listed below.
                                               _______________________________________
                                                          (Signature of Witness)

LIST OF OFFICES FOR WHICH BALLOTS DESTROYED:




CATEGORY OF DOCUMENTS AND OTHER MATERIALS DESTROYED:




* The Clerk shall retain the ballots and all other documents and materials related to an election for 120 days
after declaring the results of the election under Section 55 and, unless there is a court order that they be
retained or a recount has been commenced and not finally disposed of, shall then destroy the ballots in the
presence of two witnesses (s.88). At the time of destroying the ballots pursuant to Section 88, other
documents and other materials related to the Election (with exception of documents filed under Section 78
and 79.1) may also be destroyed.
                                                                                              39

                                                                                      Form EL39

                                     NOTICE OF RECOUNT*
                                  Municipal Elections Act, 1996 (s.56-58)




I, ______________________________________, Clerk (or designated election official)
        (name of Clerk or designate)

                                        of the Corporation of the


                    __________________ of ______________________ in the


                        ________________of ________________________

              hereby declare that a recount of the votes cast in the Municipal Election

                  held October 25, 2010, for ______________________________
                                              (state office or by-law/question)

      ______________________________ shall be held commencing at ____________ on
                                                                  (time)

      __________________________ at _______________________________________ .
           (date)                               (location)


The recount is being conducted pursuant to section ______ of the Municipal Elections Act, 1996.


Date ______________


                                                     _______________________________________
                                                                     Municipal Clerk or designate




* A recount may be held pursuant to Sections 56, 57 or 58.
                                                                                                 40

                                                                                     Form EL40

                                     RECOUNT RESULTS
                               Municipal Elections Act, 1996 (s.62(1))

The recount results for the following office or the by-law/question conducted on the _____ day

of _________________, 2010, in the ________________________________ are:
                                            (name of municipality)


Office                                  Number of                        Number of Votes
                                        Votes                            if all disputed
______________________________                                           ballots excluded

List Candidates or By-law/Question




Total Number of Ballots Disputed ________                           _________________
                                                                          (Date)

                                                          _________________________________
                                                                    Municipal Clerk or designate
                                                                                                41

                                                                                      Form EL41

                          DECLARATION OF RECOUNT RESULTS
                                 Municipal Elections Act, 1996 (s. 62 (4))

          I, _________________________________, Clerk (or designated election official)

      of the Corporation of the ____________________ of ______________________________

             in the _______________________ of ______________________________

                                                declare that:

(1)       On the ______ day of ____________________, 2010, I conducted a recount of the

          ballots cast in the Municipal Election held October 25, 2010, for:

          - the office(s) of


          - the following question or by-law:


(2)       No application has been made for a judicial recount under Section 63.

(3)       The successful candidate(s) elected is/are:




(4)       The result of the vote upon the question or by-law is:



                                                                               __________________
                                                                                            (Date)

                                                           ___________________________________
                                                                       Municipal Clerk or designate
                                                                                                  42

                                                                                      Form EL42

               NOTICE TO CANDIDATE OF FILING REQUIREMENTS
                               Municipal Elections Act, 1996 (s. 78 (6))

TO:

____________________________________________   /  ___________________________
     (Name of Candidate)                                   (Office)
____________________________________________________________________________
      (Address)                                            (Postal Code)

FROM:

The Clerk or designated election official of
_____________________________________________________________________________
                                   (Name of Municipality)

TAKE NOTICE EVERY CANDIDATE SHALL FILE by March 25, 2011, with the Clerk with whom
their nomination was filed a financial statement and auditor's report in accordance with s.78 of the
Municipal Elections Act, 1996.

78(1)   On or before 2:00 p.m. on the filing date, a candidate shall file with the Clerk with whom
        the nomination was filed a financial statement and auditor’s report, each in the prescribed
        form, reflecting the candidate’s election campaign finances,
        (a) in the case of a regular election, as of December 31 in the year of the election;
                                                        th
        (b) in the case of a by-election, as of the 45 day after Voting Day.
 (2)    If the candidate’s election campaign period continues during all or part of the
        supplementary reporting period, he or she shall, before 2 p.m. on the supplementary filing
        date, file a supplementary financial statement and auditor’s report for the supplementary
        reporting period.
 (3)    A supplementary financial statement or auditor’s report shall include all the information
        contained in the initial statement or report filed under subsection (1) and in any previous
        supplementary statement or report under subsection (2), , as the case may be, updated
        to reflect the changes to the candidate’s election campaign finances during the
        supplementary reporting period.
 (4)    An auditor’s report shall be prepared by an auditor licensed under the Public Accounting
        Act, 2004.
 (5)    No auditor’s report is required if the total contributions received and total expenses
        incurred in the election campaign up to the end of the relevant period are each equal to
        or less than $10,000.

_____________________                              ___________________________________
      Date                                               Municipal Clerk or designate

Note:   At least 30 days before the filing date, the Clerk shall give every candidate whose
        nomination was filed with him or her, notice of the filing requirements of this section.
        Notice to be given in accordance with Section 13
Also Note:       If council has passed a by-law allowing for electronic filing, candidates must also
be advised of this options and consequences or limitations associated with it.
                                                                                                                43

                                                                                                     Form EL43
                                                                                             (Prepare in triplicate)
                                        NOTICE OF DEFAULT
                                    Municipal Elections Act, 1996 (s. 80 (3))
 TO:
 _________________________________________                      /    ____________________________
       (Name of Candidate)                                                (Office)
 ___________________________________________________________________________
       (Address)                                                                     (Postal Code)

 FROM:

 The Clerk, or designated election official of
 _____________________________________________________________________________
                                         (Name of Municipality)

TAKE NOTICE that you are in default of the requirements of the Municipal Elections Act, 1996, because:

 A.    You failed to file documents with the Municipal Clerk as required by Section 78 of the Municipal
       Elections Act 1996 on or before the relevant date, or
 B.    You failed to pay the amount of the surplus shown in documents which were filed with the
       Municipal Clerk by the relevant date as required by Section 79 of the Municipal Elections Act,
       1996, or
 C.    A document filed under Section 78 of the Municipal Elections Act 1996 shows on its face that
       you have incurred expenses exceeding the amount permitted under Section 76 of that Act.

 (Insert Appropriate Wording or Use the Following Suggestions)

                           *
 NOTICE OF DEFAULT
 PLEASE SELECT THE APPROPRIATE SECTIONS ONLY

 (I)      If this notice indicates that you have failed to file a document required by Section 78 or 79.1 of the
          Municipal Elections Act, the following provisions and penalties apply:

                  TO A SUCCESSFUL CANDIDATE
             (i) you forfeit any office to which you were elected and the office shall be deemed to be vacant
             (ii) until the next regular election has taken place, you are ineligible to be elected or appointed
                  to any office to which the Municipal Elections Act, 1996 applies.
                  OR
                  TO AN UNSUCCESSFUL CANDIDATE
             (i) until the next regular election has taken place, you are ineligible to be elected or appointed
                  to any office to which the Municipal Elections Act, 1996 applies.




 *
  this portion of the suggested notice of default form provides suggested wording depending on the status of
 the candidate (elected or not elected) and the type of default.
                                                                                                             44

                                                                                        Form EL43 (Cont’d)


                                           Notice of Penalties

Sections 91 and 92 of the Municipal Elections Act, 1996 set out penalties with respect to violations under the
Act as follows:
91. (1) If a person is convicted of a corrupt practice under this Act, or of an offence under the
Criminal Code (Canada) in connection with an act or omission that relates to an election to which
this Act applies, then, in addition to any other penalty provided for in this Act,
  (a) any office to which the person was elected is forfeited and becomes vacant; and
  (b) the person is ineligible to be nominated for, or elected or appointed to, any office until the
      next two regular elections have taken place after the election to which the offence relates.
Exception
  (2) However, if the presiding judge finds that the person committed the corrupt practice or
offence under the Criminal Code (Canada) without any intent of causing or contributing to a false
outcome of the election, clause (1) (b) does not apply.
92.(3)   If the expenses incurred by or on behalf of a candidate exceed the amount determined for the office
         under section 76, the candidate is liable to a fine equal to the excess, in addition to any other penalty
         provided for in the Act.
   (5)    A candidate is guilty of an offence and, on conviction, in addition to any other penalty that may be
         imposed under this Act, is subject to the penalties described in subsection 80 (2)if he or she,
         (a) files a document under section 78 or 79.1 that is incorrect or otherwise does not comply with that
         section; or
         (b) incurs expenses that exceed what is permitted under section 76.

_____________________                                   ___________________________________
Date                                                          Municipal Clerk or designate
                                                                                                                  45



                                                                                                    Form EL46

                                          BALLOTS ACCOUNT
                                      Municipal Elections Act, 1996 (s. 54)




Ballots Received from the Clerk (Line A from Ballot Inventories)

French Language Public Ballots
French Language Separate
Ballots
English Language Public Ballots
English Language Separate
Ballots
No School Board Ballots
Total Ballots Received


Ballot Count
Ballots Counted By Vote Tabulator
Cancelled Ballots
Defective Ballots
Unused Ballots (Total all Line E’s on
Ballot Inventories)
Total Ballot Count (should equal Total
Ballots Received)

DROs’ Signature
Election Officials’ Signatures




Scrutineers’ Signatures




Distribution: yellow (original) - to be placed in special packet, blue (duplicate) - to be attached to voters' list
and placed in carrying case.
                                                                                                           46

                                                                                              Form EL47

                              ELECTION OFFICIAL APPLICATION
                                      Municipal Elections Act, 1996 (s. 15)
                                                                                                 Vote 2010
                                                                              Election Official Application

Thank you for your interest in the 2010 Municipal Elections to be held in (name of municipality).
Completed application forms can be returned, in person, to (municipality name and address).
Every applicant will be required to complete a brief written exam followed by an oral interview
upon submitting a completed application form.

Voting Day:          Monday, October 25, 2010
Advance Voting Days: To be determined

Part I (Print clearly in space provided.)
Surname                                                  Given Names

Mailing Address

City/Town                                                Postal Code

Home Phone                                               Business Phone

Ward                                                     E-Mail Address


Part II (Check Yes or No)                                                                          Yes     No
Are you a candidate or the spouse of a candidate running in the 2010 Municipal Election in
(name of municipality)
Have you worked on a federal, provincial, or municipal election before?
Do you have a valid driver’s licence?
Will you have a car at your disposal on Voting Day?
Do you know how to use a computer?
Do you feel comfortable using electronic vote counting equipment?

Part III (Check preference)
I would prefer to work in the following position:
DRO                          Poll/Clerk /Election        Information Clerk
                             Assistant
Attendance at an election training session is mandatory for all election personnel. Training sessions will be
held from ?, and ?. What is the best time for you to attend a training session?
  Daytime                                                Evening
I declare that the information provided by me in this application for employment is, to the best of my
knowledge, an accurate statement of the facts. I understand that falsified statements on this application
shall be considered sufficient cause of dismissal.
Signature                                                Date

Part IV – For Office Use Only
Home Voting Subdivision                                  Assigned Voting Subdivision

Assigned Voting Place                                    Assigned Position

NOTES:
The telephone numbers of election personnel will be shared with voting place staff for contact purposes
only.
Election personnel are asked to vote on one of the scheduled advance voting days.
Every attempt will be made to place election personnel in the ward in which they reside; however, this may
not be possible in every case.
                                                                       47

                                                                FORM EL48


                                  REFUND OF NOMINATION FEE
                                     Municipality of Brockton
                                     2010 Municipal Election




Please refund _______________________________________, candidate for
the office of

          Mayor                           □
          Deputy Mayor                         □
          Councillor                      □
          School Board                         □
The amount of $________________




_______________________________________
Signature of Clerk or designate




Dated this _________ day of _______________________, 2010

				
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