REQUEST FOR AUTHORIZATION TO PAY AN UNPAID CLAIM OR LOAN (EC 20005)
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1 REQUEST FOR AUTHORIZATION TO PAY AN UNPAID CLAIM OR LOAN (EC 20005) Introduction The Request for Authorization to Pay an Unpaid Claim or Loan must be submitted before paying a claim or loan that remains outstanding 36 months after election day, the selection date or the contest date, as the case may be. The candidate or official agent, nomination contestant or financial agent, or leadership contestant or financial agent, as well as a creditor, may use this form to request authorization from the Chief Electoral Officer. Filling Out the Request for Authorization to Pay an Unpaid Claim or Loan The form can be completed onscreen and printed, or a blank copy can be printed and completed by hand. Sections B and F must be completed by all political entities. Section B: Select the political entity for which an authorization is requested. Section F: List the details of each unpaid claim or loan covered by this request, including the amount that would be paid, the creditor s full name and the source of funds for this payment (include bank statement). Sections C, D and E must be completed by the appropriate political entity. Section C Candidate Enter the candidate s and official agent s full names, the electoral district, the name of the electoral district, the political affiliation (if any) and the date of the election. The section must be signed by the selected applicant and dated using the format yyyy/mm/dd. Refer to Annex I for a list of electoral district s and names. Section D Nomination Contestant Enter the contestant s and financial agent s full names, the electoral district, the name of the electoral district, the political affiliation and the selection date. The section must be signed by the selected applicant and dated using the format yyyy/mm/dd. Refer to Annex I for a list of electoral district s and names. Section E Leadership Contestant Enter the contestant s and financial agent s full names, the political affiliation and the contest date. The section must be signed by the selected applicant and dated using the format yyyy/mm/dd.
2 NEWFOUNDLAND Avalon Bonavista Burin Trinity Coast of Bays Central Notre Dame Labrador Long Range Mountains St. John's East / St. John's-Est St. John's South Mount Pearl / St. John's-Sud Mount Pearl PRINCE WARD ISLAND Cardigan Charlottetown Egmont Malpeque NOVA SCOTIA Cape Breton Canso Central Nova / Nova-Centre Cumberland Colchester Dartmouth Cole Harbour Halifax Halifax West / Halifax-Ouest Kings Hants Sackville Preston Chezzetcook South Shore St. Margaret's Sydney Victoria West Nova / Nova-Ouest NEW BRUNSWICK Acadie Bathurst Beauséjour Fredericton Fundy Royal Madawaska Restigouche Miramichi Grand Lake Moncton Riverview Dieppe New Brunswick Southwest / Nouveau- Brunswick-Sud-Ouest Saint John Rothesay Tobique Mactaquac QUEBEC Abitibi Baie-James Nunavik Eeyou Abitibi Témiscamingue Ahuntsic Cartierville Alfred-Pellan Argenteuil La Petite-Nation Avignon La Mitis Matane Matapédia Beauce Beauport Limoilou Bécancour Nicolet Saurel Bellechasse Les Etchemins Lévis Beloeil Chambly Berthier Maskinongé Thérèse-De Blainville Pierre-Boucher Les Patriotes Verchères Bourassa Brome Missisquoi Brossard Saint -Lambert Rimouski-Neigette Témiscouata Les Basques Charlesbourg Haute-Saint-Charles Beauport Côte-de-Beaupré Île d Orléans Charlevoix Châteauguay Lacolle Chicoutimi Le Fjord Compton Stanstead Dorval Lachine LaSalle Drummond Gaspésie Les Îles-de-la-Madeleine Gatineau Hochelaga Honoré-Mercier Hull Aylmer Joliette Jonquière La Pointe-de-l'Île La Prairie Lac-Saint-Jean Lac-Saint-Louis LaSalle Émard Verdun Laurentides Labelle Laurier Sainte-Marie Laval Les Îles Longueuil Charles-LeMoyne Lévis Lotbinière Longueuil St-Hubert Louis-Hébert Louis-Saint-Laurent Manicouagan Mégantic L'Érable
3 24048 Mirabel Montarville Montcalm Montmagny L'Islet Kamouraska Rivière-du-Loup Mount-Royal/Mont-Royal Notre-Dame-de-Grâce Westmount Outremont Papineau Pierrefonds Dollard Pontiac Portneuf Jacques-Cartier Québec Repentigny Richmond Arthabaska Rivière-des-Mille-Îles Rivière-du-Nord Rosemont La Petite-Patrie Marc-Aurèle-Fortin Saint-Hyacinthe Bagot Saint-Jean Saint-Laurent Saint-Léonard Saint-Michel Saint-Maurice Champlain Salaberry Suroît Shefford Sherbrooke Vaudreuil Soulanges Terrebonne Trois-Rivières Ville-Marie Le Sud-Ouest Île-des- Soeurs Vimy ONTARIO Ajax Algoma Manitoulin Kapuskasing Aurora Oak Ridges Richmond Hill Barrie Innisfil Barrie Springwater Oro Medonte Bay of Quinte / Baie de Quinte Beaches East York Brampton Centre Brampton East / Brampton-Est Brampton North / Brampton-Nord Brampton South / Brampton-Sud Brampton West / Brampton-Ouest Brantford Brant Bruce Grey Owen Sound Burlington Cambridge Chatham-Kent Leamington Davenport Don Valley East / Don Valley-Est Don Valley North / Don Valley-Nord Don Valley West / Don Valley-Ouest Dufferin Caledon Durham Eglinton Lawrence Elgin Middlesex London Essex Etobicoke Centre / Etobicoke-Centre Etobicoke Lakeshore Etobicoke North / Etobicoke-Nord Flamborough Glanbrook Glengarry Prescott Russell Guelph Haldimand Norfolk Haliburton Kawartha Lakes Brock Hamilton Centre / Hamilton-Centre Hamilton East Stoney Creek / Hamilton- Est Stoney Creek Hamilton Mountain Hamilton West Ancaster Dundas / Hamilton-Ouest Ancaster Dundas Hastings Lennox and Addington Huron Bruce Kanata Carleton Kenora King Vaughan Kingston and the Islands / Kingston et les Îles Kitchener Centre / Kitchener-Centre Kitchener-Conestoga Kitchener South Hespeler / Kitchener- Sud Hespeler Lambton Kent Middlesex Lanark Frontenac Kingston Leeds Grenville Thousand Islands and Rideau Lakes London Fanshawe London North Centre / London-Centre- Nord London West / London-Ouest Markham Stouffville Markham Thornhill Markham Unionville Milton Mississauga Centre / Mississauga-Centre Mississauga East Cooksville/Mississauga- Est Cooksville Mississauga Erin Mills Mississauga Lakeshore Mississauga Malton Mississauga Streetsville Nepean
4 35065 Newmarket Aurora Niagara Centre Niagara Falls Niagara West Nickel Belt Nipissing Timiskaming Northumberland Peterborough South/Northumberland Perterborough- Sud Oakville Oakville North Burlington / Oakville- Nord Burlington Oshawa Ottawa Centre / Ottawa-Centre Orléans Ottawa South / Ottawa-Sud Ottawa Vanier Ottawa West Nepean / Ottawa-Ouest Nepean Oxford Parkdale High Park Parry Sound Muskoka Perth Wellington Peterborough Kawartha Pickering Uxbridge Renfrew Nipissing Pembroke Richmond Hill Carleton St. Catharines Toronto St. Paul's Sarnia Lambton Sault Ste. Marie Scarborough Agincourt Scarborough Centre / Scarborough- Centre Scarborough Guildwood Scarborough North / Scarborough-Nord Scarborough Rouge Park Scarborough Southwest / Scarborough- Sud-Ouest Simcoe Grey Simcoe North / Simcoe-Nord Spadina Fort York Stormont Dundas South Glengarry Sudbury Thornhill Thunder Bay Rainy River Thunder Bay Superior North / Thunder Bay Superior-Nord Timmins James Bay / Timmins Baie James Toronto Centre / Toronto-Centre Toronto Danforth University Rosedale Vaughan Woodbridge Waterloo Wellington Halton Hills Whitby Willowdale Windsor Tecumseh Windsor West / Windsor-Ouest York Centre / York-Centre York Simcoe York South Weston / York-Sud Weston Humber River Black Creek MANITOBA Brandon Souris Charleswood StJames Assiniboia Headingley Churchill Keewatinook Aski Dauphin Swan River Neepawa Elmwood Transcona Kildonan St. Paul Portage Lisgar Provencher Saint Boniface Saint Vital Selkirk Interlake Eastman Winnipeg Centre / Winnipeg-Centre Winnipeg North / Winnipeg-Nord Winnipeg South / Winnipeg-Sud Winnipeg South Centre / Winnipeg- Centre-Sud SASKATCHEWAN Battlefords Lloydminster Cypress Hills Grasslands Desnethé Missinippi Churchill River / Desnethé Missinippi Rivière Churchill Carlton Trail Eagle Creek / Sentier Carlton Eagle Creek Moose Jaw Lake Centre Lanigan Prince Albert Regina Lewvan Regina Qu'Appelle Regina Wascana Saskatoon Grasswood Saskatoon University Saskatoon West Souris Moose Mountain Yorkton Melville
5 ALBERTA Banff Airdrie Battle River Crowfoot Bow River Calgary Centre / Calgary-Centre Calgary Confederation Calgary Forest Lawn Calgary Heritage Calgary Midnapore Calgary Nose Hill Calgary Rocky Ridge Calgary Shepard Calgary Signal Hill Calgary Skyview Edmonton Centre / Edmonton-Centre Edmonton Griesbach Edmonton Manning Edmonton Mill Woods Edmonton Riverbend Edmonton Strathcona Edmonton West / Edmonton-Ouest Edmonton Wetaskiwin Foothills Fort McMurray Cold Lake Grande Prairie Mackenzie Lakeland Lethbridge Medicine Hat Cardston Warner Peace River Westlock Red Deer Mountain View Red Deer Lacombe St-Albert Edmonton Sherwood Park Fort Saskatchewan Sturgeon River Parkland Yellowhead BRITISH COLUMBIA Abbotsford Burnaby North Seymour/Burnaby- Nord Seymour Burnaby South / Burnaby-Sud Cariboo Prince George Central Okanagan Similkameen Nicola Chilliwack Hope Cloverdale Langley City Coquitlam Port Coquitlam Courtenay Alberni Cowichan Malahat Langford Delta Fleetwood Port Kells Kamloops Thompson Cariboo Kelowna Lake Country Kootenay Columbia Langley Aldergrove Mission Matsqui Fraser Canyon Nanaimo ladysmith New Westminster Burnaby North Okanagan Shuswap North Vancouver Pitt Meadows Maple Ridge Port Moody Coquitlam Prince George Peace River Northern Rock Richmond Centre Esquimalt Saanich Sooke Saanich Gulf Islands Skeena Bulkley Valley South Okanagan West Kootenay / Okanagan-Sud Kootenay-Ouest South Surrey White Rock /Surrey-Sud White Rock Steveston Richmond East/Steveston Richmond-Est Surrey Centre Surrey Newton Vancouver Centre / Vancouver-Centre Vancouver East / Vancouver-Est Vancouver Granville North Island Powell River Vancouver Kingsway Vancouver Quadra Vancouver South / Vancouver-Sud Victoria West Vancouver Sunshine Coast Sea to Sky Country YUKON Yukon NORTHWEST TERRITORY Northwest Territories NUNAVUT Nunavut
001 Ajax 87, , Algoma Manitoulin 51,566 76, * 003 Aurora Oak Ridges Richmond Hill 78, ,581.70
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