FORM REG/PINAPPLICATION FOR REGISTRATION NUMBER AND PERSONAL IDENTIFICATION NUMBER (PIN)NEW 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) Website: www.elec.nj.govPLEASE BE ADVISED THAT THE REGISTRATION NUMBER AND PIN ARE NOT PRODUCED AUTOMATICALLY THROUGH ELEC'S WEBSITE.Upon receipt of the completed application, ELEC will generate a Registration Number and PIN and it will be sent via Email within the next business day.Required fields are indicated with an (*) asterisk*First Name (As it should appear on a certified report)M.I.*Last Name (As it should appear on a certified report)Suffix*Street Address 1Street Address 2*City*StateZip CodeTelephone*Email*Security Question (What is your mother's maiden name?)Check One:(Application will be rejected if email address has already been registered)CERTIFICATION:I am submitting this application for ELEC to generate my electronic signature to allow for the certification ofreports filed electronically. I certify that the statements on this document are true. I am aware that if any of the statements arewillfully false, I may be subject to punishment.Insertion in an electronic report of the registration number and personal identification number (PIN) provided by ELEC to candidates, campaign treasurers, chairpersons, organizational treasurers, governmental affairsagents, represented entities or entities communicating with the general public, shall satisfy the obligation to certify the correctness of a report required to be filed by “The New Jersey Campaign Contributions andExpenditures Reporting Act” and the “Legislative and Governmental Process Activities Disclosure Act.”This form is not intended for public disclosure and shall be provided only in redacted form pursuant to The New Jersey Open Public Records Act (N.J.S.A. 47:1A-1 et seq.)New Jersey Election Law Enforcement CommissionPage 1 of 1sForm RegPin Revised Jun. 2021
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