FORM C-1
SUPPLEMENTAL CONTRIBUTOR INFORMATION
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
P.O. Box 185, Trenton, NJ 08625-0185
(609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532)
Website: www.elec.nj.gov
CONTRIBUTIONS REPORT TYPE (Select One)
SECTION I. CANDIDATE, JOINT CANDIDATES, OR POLITICAL COMMITTEE INFORMATION
Candidate(s) Name
Committee Name
Street Address
Office Sought
City
State
Zip Code
*Day Telephone
*Evening Telephone
Election Type:
Election Date
(Select One)
County
Legal Name of Election District or Municipality
Political Party
SECTION II. CONTRIBUTION INFORMATION (Receipt Types: A = Currency or Check, B = In-Kind, C = Loan)
Date Received
Contributor Name
Address (Number and Street, City, State, Zip Code)
Aggregate Amount
Amount
Occupation (If Individual)
Description, if In-Kind Contribution
Receipt Type
Employer Name and Mailing Address (If Individual)
Date Received
Contributor Name
Address (Number and Street, City, State, Zip Code)
Aggregate Amount
Amount
Occupation (If Individual)
Description, if In-Kind Contribution
Receipt Type
Employer Name and Mailing Address (If Individual)
Date Received
Contributor Name
Address (Number and Street, City, State, Zip Code)
Aggregate Amount
Amount
Occupation (If Individual)
Description, if In-Kind Contribution
Receipt Type
Employer Name and Mailing Address (If Individual)
Grand Total:
Registration Number
PIN
Candidate or Treasurer
Date
*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 Commission
Page 1 of 1
sForm C-1 Revised Jun. 2021
Required;
Committee spending under the R-1 reporting threshold (A-1 or A-2 filers etc.) who received a contributionin excess of $300 in the aggregate from one source in the election, or any currency (cash) contributions.
Committee receiving a contribution in excess of $1,900 in the aggregate from one source starting with the13th day before the election up to, and including the day of the election (48-Hour Notice).
Required;
Primary
May Municipal
Fire District
General
Run-Off
Special
Required;
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
Required;
Required;
mm/dd/yyyy
Amendment
Check If Currency
Check If Currency
Check If Currency
Required;
GOVERNOR
SENATE
ASSEMBLY
SENATE & ASSEMBLY
COUNTY EXECUTIVE
COUNTY COMMISSIONER
CTY EXECUTIVE & COMMISSIONER
COUNTY SHERIFF
COUNTY CLERK
COUNTY REGISTRAR OF DEEDS
COUNTY SURROGATE
MAYOR
COUNCIL OR MUNICIPAL OFFICE
MAYOR & COUNCIL
FIRE COMMISSIONER
CHARTER STUDY COMMISSIONER
BALLOT QUESTION COMMITTEE
POLITICAL COMMITTEE
Required;
Required;
Required;
Required;
A
B
C
A
B
C
A
B
C
Stamp Text
Required Field
Processing Request...