FORM C-3
SUPPLEMENTAL CONTRIBUTOR INFORMATION
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
P.O. Box 185, Trenton, NJ 08625-0185
Phone: (609) 292-8700
Website: www.elec.nj.gov
CONTRIBUTIONS REPORT TYPE (Select One)
Report Quarter
Filing Year
SECTION I.
Full Committee Name
Street Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
SECTION II. CONTRIBUTION INFORMATION
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
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 3
sForm C-3a Revised Aug 2024
Required;
Committee filing "Sworn Statement, " Form A-3, and receiving a contribution in excess of $200 in the aggregate from one source, or currency (cash) contributions in any amount.
Committee receiving a contribution in excess of $200 in the aggregate from one source between the closing date of the last quarterly report through the date of an election in which the committee is contributing or otherwise participating (72/24 Hour Notice).
Required;
April 15
July 15
October 15
January 15
Individual
Non-Individual
Individual
Non-Individual
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
mm/dd/yyyyy
mm/dd/yyyyy
Required;
Required;
mm/dd/yyyy
Amendment
Check if address changed.
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
Grand Total:
New Jersey Election Law Enforcement Commission
Page 2 of 3
sForm C-3a Revised Aug 2024
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
Grand Total:
New Jersey Election Law Enforcement Commission
Page 3 of 3
sForm C-3a Revised Aug 2024
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Stamp Text
Required Field
Processing Request...