FORM C-1
SUPPLEMENTAL CONTRIBUTOR INFORMATION
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
P.O. Box 185, Trenton, NJ 08625-0185
Phone: (609) 292-8700
Website: www.elec.nj.gov
CONTRIBUTIONS REPORT TYPE (Select One)
SECTION I. CANDIDATE, JOINT CANDIDATES, OR POLITICAL COMMITTEE INFORMATION
Candidate(s) / 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
SECTION II. CONTRIBUTION INFORMATION
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
Grand Total:
Registration Number
PIN
Candidate or Treasurer
Date
*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 3
sForm C-1a Revised Aug 2024
Required;
Committee spending under the R-1 reporting threshold (A-1 or A-2 filers etc.) who received a contribution in excess of $200 in the aggregate from one source in the election, or any currency (cash) contributions.
Committee receiving a contribution in excess of $200 in the aggregate from one source starting with the13th day before the election up to, and including the day of the election (72/24 Hour Notice).
Required;
Primary
May Municipal
Fire District
General
Run-Off
Special
Individual
Non-Individual
Individual
Non-Individual
Required;
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
mm/dd/yyyyy
mm/dd/yyyyy
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;
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
Grand Total:
New Jersey Election Law Enforcement Commission
Page 2 of 3
sForm C-1a Revised Aug 2024
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Contributor Type
Last Name / Non-Individual Name
First Name (Leave blank if Non-Individual)
Street Address
City
State
Zip Code
Occupation
Date Received
Employer Name
Street Address
City
State
Zip
Receipt Type
Description, if In-Kind Contribution
Aggregate Amount
Amount
Total This Page:
Grand Total:
New Jersey Election Law Enforcement Commission
Page 3 of 3
sForm C-1a Revised Aug 2024
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
Individual
Non-Individual
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
mm/dd/yyyyy
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Accountant/Auditor
Agricultural
Architect/Surveyor/Planner
Armed Services
Arts/Entertainment
Athletics
Attorney
Business Owner
Construction Trade/Labor Trade
Consultant
Economist
Education/Professor/Teacher
Engineer
Factory Worker/Manual Worker
Financial Services/Banking
Firefighter
Homemaker
Hospitality/Hotel/Food/Beverage
Information Technology/Computer Science
Insurance
Law Enforcement
Legal Professional
Lobbyist/Government Relations
Management/Administrator/Executive
Manufacturing
Marketing/Public Relations
Mechanic/Preparer
Media
Medical Professional (Not Physician)
Office Worker
Physician
Politician
Public Sector
Real Estate
Religion
Retail Sales
Retired
Services Occupation
Social Worker
Student
Transportation
Travel/Tourism
Unemployed
Check
Cash
Electronic
In-Kind
Loan
Stamp Text
Required Field
Processing Request...