FEDERAL LIBERAL AGENCY OF BRITISH COLUMBIA
LIBERAL PARTY OF CANADA IN BRITISH COLUMBIA
460 – 580 Hornby Street, Vancouver, BC V6C 3B6
Ph: 604-664-3777 Fax: 604-874-8966 Info@lpcbc.com
ESTABLISHMENT OF SIGNING OFFICERS
Date: _______________________
This is to set up the signing officers to requisition cheques.
Signing Officer (please print):
___________________________________
Signature of Signing Officer:
___________________________________
Signing Officer (please print):
___________________________________
Signature of Signing Officer:
___________________________________
Signing Officer (please print):
___________________________________
Signature of Signing Officer:
____________________________________
Signing Officer (please print):
___________________________________
Signature of Signing Officer:
___________________________________
The Federal Liberal Agency of British Columbia requires the above information for each
individual for each authorized signing officer for each riding.
**Note – This must be accompanied with a photocopy of either your BC Drivers License
or Your Passport.
Appendix A
08/11/04
Riding
FLA #
FEDERAL LIBERAL AGENCY OF BRITISH COLUMBIA
LIBERAL PARTY OF CANADA IN BRITISH COLUMBIA
460 – 580 Hornby Street, Vancouver, BC V6C 3B6
Ph: 604-664-3777 Fax: 604-874-8966 Info@lpcbc.com
CHEQUE REQUISITION FORM
Date:
Amount Payable: $
Account Number (See list):
Payable to:
Address:
(Incl. Postal Code)
Purpose:
Signatures of two authorized signing officers:
1.
2.
**Note: - This must be accompanied with minutes of a meeting or an invoice.
Appendix B
08/11/04
Riding
FLA #
FEDERAL LIBERAL AGENCY OF BRITISH COLUMBIA
LIBERAL PARTY OF CANADA IN BRITISH COLUMBIA
460 – 580 Hornby Street, Vancouver, BC V6C 3B6
Ph: 604-664-3777 Fax: 604-874-8966 Info@lpcbc.com
DEPOSIT RECONCILIATION FORM
Date of event: ____________________________________
Description of event (if applicable). Please include a brief description of the function and
the keynote speaker.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Source of money if other than event. Please state whether contribution was from a
corporation or an individual.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Tickets sold: _______________
Price of tickets: _______________
Cash amount:
$
Cheque amount:
Credit Card amount:
Total:
$
Expenses
Total expenses for event: _______________________________________
Please provide all receipts, invoices etc.
Appendix C
08/11/04
Riding
FLA #
FEDERAL LIBERAL AGENCY OF BRITISH COLUMBIA
LIBERAL PARTY OF CANADA IN BRITISH COLUMBIA
460 – 580 Hornby Street, Vancouver, BC V6C 3B6
Ph: 604-664-3777 Fax: 604-874-8966 Info@lpcbc.com
CONFIRMATION OF CONTRIBUTION FORM
INDIVIDUALS
Full name: ______________________________________________
Address: ________________________________________________
City: ____________________ Prov.
Postal Code: ____________
Phone Number:
Contribution Amount $_______________
Method of Payment:
Cheque
Cheques are payable to the: Federal Liberal Agency of British Columbia.
**Remember to note the riding association name and number on cheque**
Credit Card Payment
 VISA
 MasterCard
Name on card ____________________________________________________________________________.
Card number ___________________________________________. Expiry date ______________________.
Cash Payment
Cash
Money Order
I, _______________________________________ have contributed $______________________
to the Federal Agency of British Columbia in cash.
Donor’s statement of compliance (to be completed by all contributors)
I confirm my eligibility to make political contributions and that the limits imposed by the Canada Elections Act have not been
exceeded. This contribution is not made from the money, property or services of another given for the purpose of making a
political contribution.
I declare that the information provided herein and that the statement made herein are complete and correct to the best of my
knowledge and belief.
_______________________________
Signature
___________________________________
Date
Appendix D
08/11/04
Riding
FLA #
FEDERAL LIBERAL AGENCY OF BRITISH COLUMBIA
LIBERAL PARTY OF CANADA IN BRITISH COLUMBIA
460 – 580 Hornby Street, Vancouver, BC V6C 3B6
Ph: 604-664-3777 Fax: 604-874-8966 Info@lpcbc.com
ANONYMOUS CONTRIBUTION FORM
CONTRIBUTION OF $20 OR LESS
Insert below details of event where contribution(s) collected. Please include a
brief description of the function and the date of the function:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Total number of people attending the event: ________________________________
Total amount of contributions collected: ___________________________________
Appendix E
08/11/04
Riding
FLA #