FORM R-1 REPORT OF CONTRIBUTIONS AND REPORT (CHECK ONE).

EXPENDITURES D 29 - DAY PRE-ELECTION

NEW JERSEY ELECTION LAW ENFORCEMENT COMMISSION D 11 - DAY PRE-ELECTION
POBox 185, Trenton, NJ 08625·0185 D 20 - DAY POST-ELECTION
(609) 292-8700 or Toll Free Within NJ 1-888-313-ELEC (3532) D Apr 15,
Web site http f1www elec state nJ us! I;iQ July 15. !MUo
CANDIDATE OR COMMITIEE NAME
(!,o/YJ m J /) ~ 77J f(_t::SI-/ .I=r"'!T J+IJrfU2_y Srry /_.1 LM I o U D Oct 15,
D Jan 15,

STREET ADDRESS
IJ o rf?Jfyx J s/ Amendment Yes ~ NoD
CITY STNo- ZIP CODE r=el~t~'ge Only
DUmONT ~98 CE/VEO
COU~ ELECTION DISTRICT OR MUNICIPALITY SEP D 7 2010
rrufY10Nr
POLITICAL PARTY, IF ANY OFFICE SOUGHT I'll
CWUI\JC! LfJ~D
ELECTION DATE ELECTION TYPE 181 PRIMARY D MUNICIPAL D GENERAL
(CHECK ONE) D RUN-OFF D SCHOOL D SPECIAL
SUMMARY TABLES DO NOT ATTEMPT TO COMPLETE TABLES I AND II UNTIL
APPROPRIATE SCHEDULES HAVE BEEN COMPLETED
TABLE I. RECEIPTS THIS REPORT CUMULATIVE TO
DATE
1 MONETARY CONTRIBUTIONS OF $300 OR LESS $ ~ $ c,tlJ(T) m(')
2 MONETARY CONTRIBUTIONS IN EXCESS OF $300 AND ALL CURRENCY $ - $ r~ //)S(C()
CONTRIBUTIONS [Schedule A]
3 IN-KIND CONTRIBUTIONS OF $300 OR LESS $ - $ 10(;,,/)-1:
4 IN-KIND CONTRIBUTIONS IN EXCESS OF $300 [Schedule B) $ ~ $
5 LOANS RECEIVED IN EXCESS OF $300 AND ALL CURRENCY LOANS $ .--- $ -
[Schedule C]
6 SUB TOTAL (ADD LINES 1 THRU 5) $ $
~ ~.R~J,t2~
7 REFUND OF EXCESSIVE CONTRIBUTIONS (Adjustment Schedule) (-) $ $ -
r--:::-_
8 TOTAL CONTRIBUTIONS $ .-- $ ~,8:a1(~!:
9 ADD FUNDS TRANSFERRED FROM PRIOR CAMPAIGN (+) $ ,.-- $ -
10 TOTAL RECEIPTS (ADD LINE 8 + LINE 9) $ .-- $ e sei.as
TABLE II EXPENDITURES
1 DISBURSEMENTS -CAMPAIGN EXPENSES [Schedule 1 (D)] $ .....--- $ --
2 DISBURSEMENTS - OTHER [Schedule 2(0)] $ .-- $ _93,'tC
3 DISBURSEMENTS - CONTRIBUTIONS MADE TO OTHER $ s (~'/30 rxi
CANDIDATES!COMMITIEES [Schedule 3(0)] -
4 CONTRIBUTIONS MADE ON BEHALF OF OTHERS $ $
-
[Pro Rata Amount Schedules 1(0) and 2(0)] --
5 IN-KIND CONTRIBUTIONS OF $300 OR LESS (TABLE I, LINE 3) $ .---- $ ac.os:
6 IN-KIND CONTRIBUTIONS IN EXCESS OF $300 (TABLE I, LINE 4) $ - $ -
7 SUB TOTAL (ADD LINES 1 THRU 6) $ - $ ... ~fa30-,OD
8 REFUNDED DISBURSEMENTS [Schedule F) (-) $ $ -
--
9 TOTAL EXPENDITURES (LINE 7 MINUS LINE 8) $ - $ 333D,OO New Jersey Election law Enrorcemenl Commission, January 2005

FORM R 1

SCHEDULE A

Monetary Contributions in Excess of $300 and All Currency Contributions

CONTRIBUTOR NAME tJ 1ft EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

ICHECK IF 0 IAGGREGATE AMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
CURRENCY $ $
OCCUPATION
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

I~HECK IF D I AGGREGATE AMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
CURRENCY $ $
OCCUPATION
-
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

ICHECK IF 0 IAGGREGATEAMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
CURRENCY $ $
OCCUPATION
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

ICHECK IF 0 IAGGREGATEAMOUNT DATE(S} RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
CURRENCY $ s
OCCUPATION
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

ICHECK IF 0 IAGGREGATEAMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
CURRENCY $ $
OCCUPATION
(COMPLETE THIS LINE FOR EVERY PAGE USED) TOTAL, THIS PAGE $ -0--
(COMPLETE THIS LINE FOR LAST PAGE USED) GRAND TOTAL $ -0- New Jersey EIec1loo Law Enforcement ComlTllsslon

2

FORMR 1 ReVised 1212008

SCHEDULE B

In·Kind Contributions In Excess of $300

CONTRIBUTOR NAME AJ fA- EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

I:GGREGATE AMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
$
OCCUPATION
DESCRIPTION OF IN-KIND CONTRIBUTION(S)
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

I:GGREGATE AMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS P-ERIOD
$
OCCUPATION
DESCRIPTION OF IN-KIND CONTRIBUTION{S)
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

I:GGREGATEAMOUNT DATE(S) RECEIVED AMOUNT(S) RECEIVED THIS PERIOD
$
OCCUPATION
DESCRIPTION OF IN-KIND CONTRIBUTION(S)
CONTRIBUTOR NAME EMPLOYER NAME
CONTRIBUTOR ADDRESS EMPLOYER ADDRESS

l:GGREGATE AMOUNT DATE(S) RECEIVED AMOUNT{S) RECEIVED THIS PERIOD
$
OCCUPATION
DESCRIPTION OF IN-KIND CONTRIBUTION(S)
(COMPLETE THIS LINE FOR EVERY PAGE USED) TOTAL, THIS PAGE $ --()-
(COMPLETE THIS LINE FOR LAST PAGE USED) GRAND TOTAL $ ---0-- New Jersey Becbon Law Enfon:ement Commosslon

3

FORM R 1 ReVISed 1212008

LENDER NAME N lit EMPLOYER NAME
LENDER ADDRESS EMPLOYER ADDRESS

OCCUPATION
CO-SIGNER NAME EMPLOYER NAME
CO-SIGNER ADDRESS EMPLOYER ADDRESS

OCCUPATION AMOUNT(S) RECEIVED THIS PERIOD
$
DATE(S) RECEIVED AGGREGATE AMOUNT CHECK IF
CURRENCY 0
$
LENDER NAME EMPLOYER NAME
LENDER ADDRESS EMPLOYER ADDRESS

OCCUPATION
CO-SIGNER NAME EMPLOYER NAME
CO-SIGNER ADDRESS EMPLOYER ADDRESS

OCCUPATION AMOUNT(S) RECEIVED THIS PERIOD
$
DATE(S) RECEIVED AGGREGATE AMOUNT CHECK IF
CURRENCY 0
$
TOTAL AMOUNT OF LOANS RECEIVED THIS REPORT PERIOD -(J--
$ SCHEDULE C

Loans Received in Excess of $300 and All Currency Loans

New Jersey ElectIon law Enfon:ement CommlssiCll

4

FORM R-l Re..sed 12/2006

L_

ADJUSTMENT SCHEDULE Refund of Excessive Contributions

PAYMENT DATE CHECK NO PAYEE NAME AND ADDRESS REFUNDED AMOUNT
rJ/iJ- $
,
(COMPLETE THIS LINE FOR EVERY PAGE USED) TOTAL, THIS PAGE $ --n ,-

(COMPLETE THIS LINE FOR LAST PAGE USED) GRAND TOTAL $ ~ New Jersey Election Law Enforcement CommisSIon

5

FORM R·1 Revised 1212008

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SCHEDULE E Outstanding Obligations

Date Incurred Creditor's Name Address Description Amount
;J III $
- -
TOTAL $
OUTSTANDING "L5
OBLIGATIONS ---- SCHEDULE F

Refunded Disbursements

Date Full Name Address Descnptlon Amount
tviA- $
SCHEDULE F TOTAL $ -f)..-- New Jersey EleclJon Law Enforcement CoIlVTlsslOn

9

FORM R t ReVISed 1212008

SCHEDULE G Recipients of In-Kind Contributions

NAME OF RECIPIENT CANDIDATE/COMMITTEE
,J fir
MAILING ADDRESS
OFFICE SOUGHT ELECTION DISTRICT OR MUNICIPALITY
CHECK NUMBER PAYMENT DATE AMOUNT
$
NAME OF RECIPIENT CANDIDATE/COMMITTEE
MAILING ADDRESS
OFFICE SOUGHT ELECTION DISTRICT OR MUNICIPALITY
- -
CHECK NUMBER PAYMENT DATE AMOUNT
$
NAME OF RECIPIENT CANDIDATE/COMMITTEE
MAILING ADDRESS
OFFICE SOUGHT ELECTION DISTRICT OR MUNICIPALITY
CHECK NUMBER PAYMENT DATE AMOUNT
$
NAME OF RECIPIENT CANDIDATE/COMMITTEE
I
MAILING ADDRESS
OFFICE SOUGHT ELECTION DISTRICT OR MUNICIPALITY
CHECK NUMBER PAYMENT DATE AMOUNT
$
NAME OF RECIPIENT CANDIDATE/COMMITTEE
MAILING ADDRESS
OFFICE SOUGHT ELECTION DISTRICT OR MUNICIPALITY
CHECK NUMBER PAYMENT DATE AMOUNT
$ .e-> New Jen;ey EiedlOfl Law enforcement CommISSIon

10

FORM R 1 ReVised 1212Q08

STATEMENT OF CAMPAIGN DEPOSITORY AND CAMPAIGN TREASURER

Opening Balance, this report

(Insert closing balance of last report, or, If this IS the first report filed by this entity for this election, Insert zero )

$

Funds Transferred from Prior Campaign

$

$

-

Deposits (Include Interest)

Disbursements (Include bank charges)

$

Closing Balance. this Report

NAME OF BANK OR DEPOSITORY

ACCOUNT NUMBER

12(02 tAJAStl/NG77J IV fhj ~ I f/)()IfY7DtJrr N::I 6?h 98

NAME OF ACCOUNT

ADDRESS OF BANK OR DEPOSITORY

~MI::J7F Ai JMR-Ek

NAMEOTREASURER ; "TELEPHONE NUMBER (DAY)

ILl' EJ LfNfD eJ I)1JG ~('OZDtJrr IVa t29k$

CERTIFICATION

I certify that the statements on this document are true, and that the contnbutlon amounts ec IV d desiqnated by law I am aware that If any of the statements are willfully false, I may be subjec to

gfpDltD

DATE

ATE)

PRINT FULL NAME (CANDIDATE)

DATE

PRINT FULL NAME (CANDIDATE)

SIGNATURE (CANDIDATE)

DATE

81J.p/ltJ

TE

PRINT FULL NAME (CANDIDATE) SIGNATURE (CANDIDATE)

fbWN!tf)1-!57F fJUI~ ~

PRINT FULL NAME (TREASURER) ---r=~1 ~NIof:07~T~~E=-=(T~R-=EA-:-S~U-:-:::R::-::::E::-::::R-:-)--

Treasurers for Gubernatorial and Legislative candidates are required to receive training with the New Jersey Election Law

Enforcement Commission Check here 0 If you have completed the trairunq and enter your Treasurer Training ID# _

DECLARATION OF FINAL REPORT

If this IS the final report, sign applicable Declaration below as well as Certification above Chapter 65 of the Laws of 1993 requires that all filing entities continue to file reports with the CommiSSion until all campaign business IS wound up and the fund IS dissolved

D I certify that all contributions or other rnorues received by ttus election fund have been disbursed, that there are no outstanding loans or other obligations, and that the election fund has wound up Its business and has been dissolved

SIGNATURE (CANDIDATE)

DATE

PRINT FULL NAME (CANDIDATE)

DATE

PRINT FULL NAME (CANDIDATE)

SIGNATURE (CANDIDATE)

DATE

PRINT FULL NAME (CANDIDATE)

SIGNATURE (CANDIDATE)

DATE

PRINT FULL NAME (TREASURER)

SIGNATURE (TREASURER)

New Jeln), Elet;lJon lJJw Enforcement CommiSSIOn, January 2005 11

'Leave this field blank It your telephone number Is unlisted Pursuant to.fi.,!,§,6 47 tA-tt, an unlisted telephone number IS not a publIc record and must not be provided on this form

FORM R-t