FORM D-3
POLITICAL PARTY COMMITTEE -
DESIGNATION OF ORGANIZATIONAL
TREASURER AND DEPOSITORY
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
P.O. Box 185, Trenton, NJ 08625-0185
Phone: (609) 292-8700
Website: www.elec.nj.gov
Committee Name (required)
Street Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
ELEC Identification Number
Committee Email (Optional)
Committee Website (Optional)
County
Municipality
Political Party
Type of Filing:
to June 30,
Chairperson Name
Mailing Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
Treasurer Name (required)
Mailing Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
Resident Address
City
State
Zip Code
Depository Information
Name of Bank or Depository
Mailing Address
City
State
Zip Code
Day Telephone
Account Name
Account Number
*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 2
sForm D-3 Revised Jan. 2023
Required;
State Committee
County Committee
Municipal Committee
Required;
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
Format : Zipcode
Format : Zipcode
Format : Zipcode
Format : Zipcode
Amendment
Annual Designation for July 1,
Amendment (please specify)
Deputy Treasurer
Additional Depository
Required;
Required;
Required;
DEMOCRAT
REPUBLICAN
GREEN
LIBERTARIAN
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Depository Information (continued)
Name of Bank or Depository
Mailing Address
City
State
Zip Code
Day Telephone
Account Name
Account Number
LIST THE NAME(S), MAILING ADDRESS(ES) AND TELEPHONE NUMBER(S) OF ANY PERSON(S) AUTHORIZED TO SIGN
CHECKS OR OTHERWISE MAKE TRANSACTIONS
Name
Mailing Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
Name
Mailing Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
Name
Mailing Address
City
State
Zip Code
*Day Telephone
*Evening Telephone
CHAIRPERSON/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.
Registration Number
PIN
Date
Chairperson
Registration Number
PIN
Treasurer (required)
Date
Treasurers for State Political Party Committees 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 Commission
Page 2 of 2
sForm D-3 Revised Jan. 2023
Format : Zipcode
Format : Zipcode
Format : Zipcode
Format : Zipcode
mm/dd/yyyy
mm/dd/yyyy
Stamp Text
Required Field
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