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
(609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532)
Website: www.elec.nj.gov
State Committee
County Committee
Municipal Committee
Committee Name
Street Address
City
State
Zip Code
*(Area Code) Day Telephone
*(Area Code) Evening Telephone
ELEC Identification Number
Committee Email
Committee Website
(Optional)
(Optional)
County
Municipality
Political Party
DEMOCRAT
REPUBLICAN
GREEN
LIBERTARIAN
Type of Filing:
2012
2013
2014
2015
2016
2017
2018
2019
2020
2013
2014
2015
2016
2017
2018
2019
2020
2021
Annual Designation for July 1,
to June 30,
Amendment (please specify)
Additional Depository
Deputy Treasurer
Chairperson Name
Mailing Address
City
State
Zip Code
*(Area Code) Day Telephone
*(Area Code) Evening Telephone
Treasurer Name
Mailing Address
City
State
Zip Code
*(Area Code) Day Telephone
*(Area Code) Evening Telephone
Resident Address
City
State
Zip Code
Depository Information
Name of Bank or Depository
Mailing Address
City
State
Zip Code
(Area 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.
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sForm D-3 Revised Jun. 2020
New Jersey Election Law Enforcement Commission
Depository Information (continued)
Name of Bank or Depository
Mailing Address
City
State
Zip Code
(Area 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
*(Area Code) Day Telephone
*(Area Code) Evening Telephone
Name
Mailing Address
City
State
Zip Code
*(Area Code) Day Telephone
*(Area Code) Evening Telephone
Name
Mailing Address
City
State
Zip Code
*(Area Code) Day Telephone
*(Area Code) 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
Date
Treasurer
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.
sForm D-3 Revised Jun. 2020
New Jersey Election Law Enforcement Commission
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