FORM A-3COMMITTEE - SWORN STATEMENT To be used only by a continuing political committee, political party committee, or a legislative leadership committee.NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION P.O. Box 185, Trenton, NJ 08625-0185 Phone: (609) 292-8700Website: www.elec.nj.govCalendar Year PeriodCommittee Type:Jan. 1st to Dec. 31st, Committee NameStreet AddressCityStateZip CodeELEC Identification NumberCommittee EmailWebsite Committtee(Optional)(Optional)Committee Chairperson and Treasurer Certification I, the undersigned, do hereby certify as follows:The total amount to be expended by this committee shall be zero, or shall not, in the aggregate, exceed $7,200 during the calendar year period indicated above. I have read the additional filing information on this form. I certify that my statements on this document are true. I am aware that if any of the statements are willfully false, I may be subject to punishment.Registration NumberPINRegistration NumberPINDateDateChairpersonTreasurerAddressAddressCityCityStateZip Code*Day TelephoneStateZip Code*Day Telephone*Evening Telephone*Evening TelephoneAdditional Filing InformationIn the event the total expended by this committee, in the aggregate, exceeds $7,200 at any point in the calendar year, this committee is required to file a "Receipts and Expenditures Quarterly Report," Form R-3, on each subsequent quarterly filing date. The first of such reports shall include all activity dating back to January 1st of the current calendar year. The filing dates are: April 15, July 15, October 15, and January 15.If contributions from any one source during the calendar year aggregate more than $300, or the committee receives currency (cash) contributions in any amount, the committee is required to report the contributions to the Commission on "Supplemental Contributor Information," Form C-3, on the next quarterly reporting date. Note that currency (cash) contributions cannot be accepted in excess of $200.If the committee receives a contribution in excess of $1,900 in the aggregate from any one source during the period between the closing date of the last quarterly report through the date of an election in which the committee is contributing or otherwise participating, the committee is required to notify the Commission in writing within 48 hours of the receipt of the contribution. It is permissible for a committee to file a cumulative report on the 11th day prior to an election of contributions in excess of $1,900 received up to the 13th day before an election. Thereafter, each contribution in excess of $1,900 must be reported within 48 hours of receipt. Please use the "SupplementalContributor Information," Form C-3.If the committee makes, incurs, or authorizes an expenditure of money or other thing of value in excess of $1,900 in the aggregate from April 1 up to and including the day of any primary election in which the committee is participating, or from October 1 up to and including the day of any general election in which the committee is participating, the committee is required to notify the Commission in writing within 48 hours. It is permissible for a committee to file a cumulative report on the 11th day prior to the primary or general election of expenditures made, incurred, or authorized in excess of $1,900 up to the 13th day before the election; thereafter, each expenditure in excess of $1,900 must be reported within 48 hours. Please use the "Supplemental Expenditure Information," Form E-3.*Leave this field blank if your telephone number is unlisted. Pursuant to N.J.S.A. 47:1A-1.1, an unlisted telephone number is not a public record and must not be provided on this form.New Jersey Election Law Enforcement CommissionPage 1 of 1sForm A-3 Revised Jan. 2023
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