FORM E-3SUPPLEMENTAL EXPENDITURE INFORMATION
NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION  P.O. Box 185, Trenton, NJ 08625-0185 (609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532) Website: www.elec.state.nj.us
Amendment
To be filed by a committee within 48 hours of any expenditure of money or other thing of value in excess of $1,400 in the aggregate made, incurred, or authorized from April 1 up to and including the day of any primary election in which the committee is participating, or from October 1 up to and including the day of any general election in which the committee is participating.
Filing Period (Select One)From April 1st up to and including the Primary Election DateFrom October 1st up to and including the General Election Date
Full Committee NameStreet AddressCityStateZip Code*(Area Code) Day Telephone*(Area Code) Evening TelephoneELEC Identification Number
EXPENDITURE INFORMATIONPayment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeIndependent ExpenditureFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated Amount
Payment DateCheck No.PurposeAmount Incurred/Not PaidAmount DisbursedFull Name of PayeeIndependent ExpenditureFull Mailing AddressExpenditures on Behalf of Candidate(s)/Committee(s) (Identify Recipient)Candidate/Committee Full NameElection DateElection District or MunicipalityProrated Amount
Grand Total
Registration NumberPINDateTreasurer*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.sForm E-3 Revised Jul. 2013New Jersey Election Law Enforcement CommissionPage 1 of 1
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