Professional Campaign FundraiserFORM FRRREGISTRATION STATEMENTNEW JERSEY ELECTION LAW ENFORCEMENT COMMISSIONP.O. Box 185, Trenton, NJ 08625-0185(609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532)www.elec.nj.gov1. Professional Campaign FundraiserName of Professional Campaign FundraiserBusiness NameBusiness Address (Number and Street)Business Address (City, State and Zip Code)Day Telephone*Evening Telephone*Regular Occupation or BusinessRegistration #2. Type of Report 3. Service of Legal Process - Name and Resident Address of a New Jersey Resident Who Has Been Designated as the Professional Campaign Fundraiser's Agent for the Service of Legal ProcessNameAddress (Number and Street)Address (City, State and Zip Code)4. General Nature of the ServicesBriefly Describe the Services You Will Provide as a Professional Campaign Fundraiser5. Fundraising EventsDate of EventLocation of EventAddress (Number and Street)Address (City, State and Zip Code)Amount(s) Raised at EventDescribe Event*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 2Form FRR Revised: Jun. 2021
5. Fundraising Events (cont.)Date of EventLocation of EventAddress (Number and Street)Address (City, State and Zip Code)Amount(s) Raised at EventDescribe EventDate of EventLocation of EventAddress (Number and Street)Address (City, State and Zip Code)Describe EventAmount(s) Raised at Event6. Employees of the Fundraiser - Please List the Name of Each Individual Employed By the Professional Campaign FundraiserWho Receives Monetary Compensation of At Least $5,000 Per Year to Perform Any Service Directly Related to the Solicitationof Contributions for a Candidate or Committee.Name of IndividualAddress (Number and Street)Address (City, State and Zip Code)Day Telephone*Evening Telephone*Name of IndividualAddress (Number and Street)Address (City, State and Zip Code)Day Telephone*Evening Telephone*Name of IndividualAddress (Number and Street)Address (City, State and Zip Code)Day Telephone*Evening Telephone*Professional Campaign Fundraiser CertificationI certify that the statements on this document are true and correct. I am aware that if any of the statements on this document are willfully false, I may be subject to punishment.Registration NumberPINSignature of Professional Campaign FundraiserDate*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 2Form FRR Revised: Jun. 2021
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