FORM C-3
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)
ELEC Identification Number
Report Quarter
Filing Year
SECTION I.
Full Committee Name
Street Address
City
State
Zip Code
SECTION II. CONTRIBUTION INFORMATION
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Total This Page
Grand Total
Registration Number
PIN
Signature
Date
New Jersey Election Law Enforcement Commission
Page 1 of 4
sForm C-3a Revised May 2023
Required;
Committee filing "Sworn Statement," Form A-3, and receiving a contribution in excess of $300 in the aggregate from one source, or currency (cash) contributions in any amount.
Committee receiving a contribution in excess of $1,900 in the aggregate from one sourceELEC Identification Numberbetween the closing date of the last quarterly report through the date of an election in which the committee is contributing or otherwise participating (48-Hour Notice).
Required;
April 15
July 15
October 15
January 15
Required;
Required;
Required;
Required;
Required; Format : Zipcode 12345 or 12345-1234
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
Required;
Required;
mm/dd/yyyy
Amendment
Check if address changed.
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
SECTION II. CONTRIBUTION INFORMATION - CONTINUED
Contributor Name and Address (Number, Street, City, State and Zip Code)`
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
Page 2 of 4
sForm C-3a Revised May 2023
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
Format : Date mm/dd/yyyy
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
SECTION II. CONTRIBUTION INFORMATION - CONTINUED
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
Page 3 of 4
sForm C-3a Revised May 2023
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
mm/dd/yyyy
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
SECTION II. CONTRIBUTION INFORMATION - CONTINUED
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Contributor Name and Address (Number, Street, City, State and Zip Code)
Employer Name and Address (If Individual)
Date Received
Aggregate Year to Date
Amount
Occupation (if individual)
Description, If In-Kind Contribution
Receipt
Type:
Total This Page
Grand Total
New Jersey Election Law Enforcement Commission
Page 4 of 4
sForm C-3a Revised May 2023
mm/dd/yyyy
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Check
Cash
Electronic
In-Kind
Loan
Stamp Text
Required Field
Processing Request...