FORM E-1SUPPLEMENTAL EXPENDITURE INFORMATIONNEW 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.govTo be filed within 48 hours of expenditure by a candidate, joint candidates committee, or a political committee expending in excess of $1,900 starting with the 13th day prior to the election up to, and including, the day of the election.Candidate(s) NameCommittee NameStreet AddressOffice SoughtCityStateZip Code*Day Telephone*Evening TelephoneElection DateElection Type: CountyLegal Name of Election District or MunicipalityPolitical PartyEXPENDITURE INFORMATIONPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountTotal This PageGrand TotalRegistration NumberPINDateCandidate or Treasurer*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 4sForm E-1SBa Revised Jun. 2021
Payment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountTotal This PageGrand TotalNew Jersey Election Law Enforcement CommissionPage 2 of 4sForm E-1SBa Revised Jun. 2021
Payment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountTotal This PageGrand TotalNew Jersey Election Law Enforcement CommissionPage 3 of 4sForm E-1SBa Revised Jun. 2021
Payment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated AmountTotal This PageGrand TotalNew Jersey Election Law Enforcement CommissionsForm E-1SBa Revised Jun. 2021Page 4 of 4
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