FORM E-1
SUPPLEMENTAL EXPENDITURE INFORMATION
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
P.O. Box 185, Trenton, NJ 08625-0185
Phone: (609) 292-8700
Website: www.elec.nj.gov
To be filed within 72 or 24 hours of any expenditure by a candidate, joint candidates committee, or a political committee expending in
excess of $200 starting with the 13th day prior to the election up to, and including, the day of the election.
Candidate(s) Name
Committee Name
Street Address
Office Sought
City
State
Zip Code
*Day Telephone
*Evening Telephone
Election Date
Election Type:
(Select One)
County
Legal Name of Election District or Municipality
Political Party
EXPENDITURE INFORMATION
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Total This Page
Grand Total
Registration Number
PIN
Date
Candidate 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 Commission
Page 1 of 4
sForm E-1a Revised Jul. 2023
Required;
Primary
May Municipal
Fire District
General
Run-Off
Special
Required;
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
mm/dd/yyyy
Required;
Required;
mm/dd/yyyy
Amendment
Required;
GOVERNOR
SENATE
ASSEMBLY
SENATE & ASSEMBLY
COUNTY EXECUTIVE
COUNTY COMMISSIONER
CTY EXECUTIVE & COMMISSIONER
COUNTY SHERIFF
COUNTY CLERK
COUNTY REGISTRAR OF DEEDS
COUNTY SURROGATE
MAYOR
COUNCIL OR MUNICIPAL OFFICE
MAYOR & COUNCIL
FIRE COMMISSIONER
CHARTER STUDY COMMISSIONER
BALLOT QUESTION COMMITTEE
POLITICAL COMMITTEE
Required;
Required;
Required;
Required;
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
Page 2 of 4
sForm E-1a Revised Jul. 2023
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
Page 3 of 4
sForm E-1a Revised Jul. 2023
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Payment Date
Check No.
Purpose
Amount Incurred/Not Paid
Amount Disbursed
Full Name of Payee
Full Mailing Address
Expenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)
Candidate/Committee Full Name
Election Date
Election District or Municipality
Prorated Amount
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
sForm E-1a Revised Jul. 2023
Page 4 of 4
Stamp Text
Required Field
Processing Request...