FORM D-2JOINT CANDIDATES COMMITTEE - CERTIFICATE OF ORGANIZATION AND DESIGNATION OF CAMPAIGN TREASURER AND DEPOSITORYNEW 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.govJoint Candidates Committee NameCandidate NameCandidate NameOffice SoughtOffice SoughtCandidate NameCandidate NameOffice SoughtOffice SoughtCandidate NameCandidate NameOffice SoughtOffice SoughtStreet AddressCityStateZip Code*Day Telephone*Evening TelephoneCommittee EmailCommittee Website(Optional)(Optional)Election DateElection Type: (Select One)CountyLegal Name of Election District or MunicipalityPolitical PartyCHAIRPERSONNameMailing AddressCityStateZip Code*Day Telephone*Evening TelephoneTREASURERNameMailing AddressCityStateZip Code*Day Telephone*Evening TelephoneResident AddressCityStateZip Code*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 2sForm D-2 Revised Jun. 2021




DEPOSITORY INFORMATIONName of Bank or DepositoryMailing AddressCityStateZip CodeDay TelephoneAccount NameAccount NumberLIST THE NAME(S), MAILING ADDRESS(ES) AND TELEPHONE NUMBER(S) OF ANY PERSON(S) AUTHORIZED TO SIGN CHECKS OR OTHERWISE MAKE TRANSACTIONSNameMailing AddressCityStateZip Code*Day Telephone*Evening TelephoneNameMailing AddressCityStateZip Code*Day Telephone*Evening TelephoneNameMailing AddressCityStateZip Code*Day Telephone*Evening TelephoneCANDIDATE CERTIFICATION: I certify that the statements on this document are true. I further certify that I have not, and will not during the existence of the candidate committee, establish, authorize the establishment of, maintain, or participate directly or indirectly in the management or control of any political committee or continuing political committee. I am aware that if any of the statements arewillfully false, I may be subject to punishment.DateRegistration NumberCandidatePINPINDateRegistration NumberCandidateDateRegistration NumberPINCandidateDateRegistration NumberPINCandidateDateRegistration NumberPINCandidateDateRegistration NumberPINCandidateCHAIRPERSON/TREASURER CERTIFICATION: I certify that the statements on this document are true. I am aware that if any of the statements are willfully false, I may be subject to punishment.DateRegistration NumberPINChairpersonDateRegistration NumberPINTreasurerTreasurers for Gubernatorial and Legislative candidates are required to receive training with the NJ ELEC. If you have completed the training enter your Treasurer Training ID#*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 2 of 2sForm D-2 Revised Jun. 2021
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