This form can be electronically ?led at: 

 

SUPPLEMENTAL CONTRIBUTOR INFORMATION

'J'n F'ulcttit .. 34?-

NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION
I imwwi'm 15. - PO. Box 185, Trenton, NJ 08625-0185

    

 

FORM C-1

 

FOR STATE USE ONLY

 

 

EL EC 

 

 

 

 

 

 

 

 

 

 

 

. . 4* (609) 292-8700 or Toll Free within NJ 1-888-313-ELEC (3532)
in 
CONTRIBUTIONS REPORT TYPE (CHECK ONE) 0973 2018
ommittee spending under the R-1 reporting threshold (A-l or A-2 etc.) who received a contribution in
excess of $300 in the aggregate from one source in the eiection, or any currency (cash) contributions. Amendment?
Committee receiving a contribution in excess Of $1,600 in the aggregate from one source starting with the 13TH
day before the election up to, and including the day of the election (48-Hour Notice}. Yes No
SECTION I. CANDIDATE, JOINT CANDIDATES, OR POLITICAL COMMITTEE INFORMATION
Candidate(s) Name Eiection lDatr
510K POT Ros kw 610/ 8
Committee Name Election Districtilvluni?ip 
mt Co mm. . Rascal/e 

 

Candida eh or Committee Address (Number and Street. City, State Zip Code)
32V) hates?: Ave. Roselle Pam ~15; ovaov

 

Of?ce Sought County *(Area) Day Tele hone
306 (mm, (wmtl 

 



 

 

 

 

 

 

 

 

 

 

Political Party *(Area) Evening Telephone
Qem 

SECTION il. CONTRIBUTION INFORMATION {Receipt Types: Currency or Check; 8 ln-Kind; Loan)
Date eceived Contributor Nam

IOFIISJ oselele Path Dwomiic Canon/I?M
Ad'dressN Vlu umber and Street City State Cage) Aggregate Amount Amoun?
3n 8 ekt?cnl/Ivt RosaIZI-pe we N5- 0990/ 5/17 00
Occupation (if individual) Recei tType Check if Description, if In-Kind Contribution

1; Currency CI mf-lxcees mm yrs/a3

 

Employer Name (if lndividuai) Employer Mailing Address (If Individual)

 

 

 

[)latoe??e ceivrda 9.0] 8) Contributor Nan]? 0 SO ?2 POP IC. 

 

Addre?s Nu'mbe and Street, City State Zip Codelb Aggregate Amount
It M) 07904

?m??3i9c. c/a

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

311 ha. MN 9% Rex/I9. 5
Occupation (If individual) Recei Type Check if Description, Kind Contribution

Currency 0 MWI L013
Employ Na if Individual) Emplaier Mailing Address (If individual)

Contributor (t
. 

Address (Ndmber and Street City, State Zip Code) Aggregate Amount Amount
3n Shg??g Rosuu Pout NS mm 1330.?
Occupation (If Individual) Receipt Type Check if Description, If in Kind Contribution

Currency I 6N5
Employer Name (If individual) Employer Mailing Address (If Individual)
Date Received Contributor Name
Address (Number and Street, City, State, Zip Code) Aggregate Amount Amount



Occupation (If Individual) Receipt Type Check if Description, if ln-Kind Contribution

Currency
Employer Name (If Individual) Employer Address (If Individual)
(COMPLETE THIS LINE FOR EVERY PAGE USED) TOTAL, THIS PAGE THIS LIN ST PAGE USED) GRAND TOTAL 

I.

.591

 

 

 

 

 

New Jersey Election Law Enforcement Commission

mama 1(9 J24 [i 

 

 

Form C-l Revised: 11IOTJ2016

?Leave this ?eld biank if your ieiephcne number Is uniisted. Pursuant to N. A. 1, an uniisted teiephone number is not a public record and must not be provided on this form.