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Forms and Templates

For the health and safety of staff and visitors during the COVID-19 outbreak, the Campaign Finance Board's office remains closed to the public and staff is providing all services remotely. The Candidate Services Unit is available via email at CandidateServices@nyccfb.info or audio calls via Microsoft Teams by appointment during normal business hours (9 AM – 5 PM). All forms and documents will be accepted electronically. Please fill out the applicable form completely, sign, and submit it as a single PDF to documents@nyccfb.info.
Campaigns have reported that emails sent from CFB addresses are delivered to their Spam folder. Anyone in contact with the CFB should monitor their Spam folder for CFB communications.
FORMS
TEMPLATES

The CFB Portal enables campaigns and political committees to register with the CFB and keep their registration up-to-date online, replacing many of the paper forms you previously had to fill out, have notarized, and submit via mail or email. If you need assistance setting up your CFB portal account, please contact Candidate Services at CandidateServices@nyccfb.info. All candidates running for mayor, public advocate, comptroller, borough president, or City Council Member must register and file disclosure with the CFB using the Portal, so set up your portal account and register today! (See Getting Started for more information.)

A few campaign activities and updates still require the use of forms, including the following:

Certified Statement of Active Candidacy
Participating candidates who lost a primary election but are on the ballot for the general election on another party or independent line must submit this form and documentation that they are continuing to actively campaign for the general election in order to be eligible to receive any general election public funds payments.

Certified Statement of Need
Submit a Statement of Need with supporting documentation under the following conditions: (1) To receive any pre-ballot public funds unless you are running for an open seat (no incumbent is running for re-election) or an opponent has already received public funds; (2) To lift the 25% cap on post-ballot primary payments unless you are running for an open seat or your primary opponent has already received public funds; or (3) To lift the 25% cap on general election payments even for open seats unless an opponent has already received public funds for the general election. See the Statement of Need Guide for more information.

Rescission of Certification
Submit the Rescission of Certification if you wish to rescind your Certification, and no longer be a participant in the matching funds program.
Note: this form must be submitted no later than the legal certification deadline for your election cycle, and is not reversible.

Statement of Eligibility for Childcare Expenditures
Candidates who wish to make expenditures for childcare services under Local Law 196/2018 must complete and submit this form to the CFB prior to making any campaign-related childcare expenditures. See the Childcare Expenditures Guide.

Use the following forms to keep documentation required by the Campaign Finance Act and Rules. You will upload the completed forms to C-SMART to document certain types of transactions and submit them as part of your disclosure statements.

Advance Repayment Voucher
Use the Advance Repayment Voucher if you need to repay an advance (e.g., to reimburse a campaign staffer for a campaign expense paid out of pocket).

Automobile Travel Expenses Log
Use the Automobile Travel Expenses Log to document and provide reimbursement for campaign-related personal vehicle use.

Intermediary Statement
Submit an Intermediary Statement for each individual/entity who solicits contributions for your campaign. A form should also be submitted for anyone who delivers (or directs someone to deliver) contributions to your campaign or fundraising agent.
Note: You must also obtain documentation for each contribution an intermediary solicits or delivers.

Loan Agreement
If your campaign chooses to take out a loan to cover expenses, the lender and the campaign must complete a loan agreement.

Subcontractor Disclosure
Vendors must fill out a Subcontractor Disclosure form to disclose any individual or entity they have hired to perform work contracted between them and your campaign.

Time Sheet – Daily
Use the Daily Time Sheet to document hours, duties, and wages of single-day or part-time campaign employees.

Time Sheet – Weekly
Use the Weekly Time Sheet to document hours, duties, and wages of part-time and full-time campaign employees.

Transfer Authorization Card
If your campaign intends to transfer funds, first obtain a list of all contributions received by the transferor committee to determine which contributions can be transferred. Then have the contributor complete a Transfer Authorization Card. The contribution must be from their personal funds and cannot be reimbursed in any manner.

Post-Election Forms

Use the following forms when responding to the CFB’s requests for documentation during the post-election audit process.

Candidate Family and Business Expenditure Form
All campaigns are required to complete and submit this form as part of the post-election audit process. Use this form to disclose expenditure payments to the Candidate’s family and/or expenditure payments to a business in which the Candidate or Candidate’s family has at least 10% ownership, or to confirm you did not make any.

Campaign Communications Disclosure Form
All campaigns are required to complete and submit this form as part of the post-election audit process. Use this form to itemize all campaign materials (including campaign literature) used to communicate with voters and submit samples of all materials.

Joint Expenditure Disclosure Form
All candidates are required to complete and submit this form as part of the post-election audit process. Use this form to disclose any joint expenditures your campaign made with another candidate(s), such as for shared campaign materials or activities.

Contribution Cards

For monetary contributions, have the contributor fill out and sign a contribution card. The CFB-provided template includes all of the contributor’s information and verification statements required by the Act & Rules.

Contribution Cards

Cash/Check/Money Order
English | العربية (Arabic) | বাঙালি (Bengali) | 简化字 (Simplified Chinese) | 正體字 (Traditional Chinese) | Français (French) | Kreyòl ayisyen (Haitian Creole) | हिंदी (Hindi) | 한국어 (Korean) | Polskie (Polish) | ਪੰਜਾਬੀ (Punjabi) | Pусский (Russian) | Español (Spanish) | اردو (Urdu)

Credit Card
English | العربية (Arabic) | বাঙালি (Bengali) | 简化字 (Simplified Chinese) | 正體字 (Traditional Chinese) | Français (French) | Kreyòl ayisyen (Haitian Creole) | हिंदी (Hindi) | 한국어 (Korean) | Polskie (Polish) | ਪੰਜਾਬੀ (Punjabi) | Pусский (Russian) | Español (Spanish) | اردو (Urdu)

Special Election Contribution Cards

Cash/Check/Money Order
English | العربية (Arabic) | বাঙালি (Bengali) | 简化字 (Simplified Chinese) | 正體字 (Traditional Chinese) | Français (French) | Kreyòl ayisyen (Haitian Creole) | हिंदी (Hindi) | 한국어 (Korean) | Polskie (Polish) | ਪੰਜਾਬੀ (Punjabi) | Pусский (Russian) | Español (Spanish) | اردو (Urdu)

Credit Card
English | العربية (Arabic) | বাঙালি (Bengali) | 简化字 (Simplified Chinese) | 正體字 (Traditional Chinese) | Français (French) | Kreyòl ayisyen (Haitian Creole) | हिंदी (Hindi) | 한국어 (Korean) | Polskie (Polish) | ਪੰਜਾਬੀ (Punjabi) | Pусский (Russian) | Español (Spanish) | اردو (Urdu)

TIE Donation Card
Use this donation card for all donations to your Transition and Inauguration Entity (TIE). For monetary contributions, have the donor fill out and sign a donation card. The CFB-provided template includes all of the donor’s information and verification statements required by the Act & Rules.

Contribution Card for Segregated Bank Account
Use this contribution card if you are soliciting contributions to pay debts from previous election cycles, or for use other than by your committee for the current election cycle. You must disclose your Segregated Bank Account with the CFB prior to accepting any contributions of this type.

In-Kind Contribution Card
Use the in-kind contribution card to collect information on goods or services donated to your campaign free of charge or at a discount that is not available to the general public. You may get a letter or other form of documentation detailing the same information from the contributor in lieu of using this card.
Note: You must also attach documentation substantiating the fair market value of the in-kind contribution.

Invalid Matching Claims Letters

A statement review is issued to each campaign after the CFB reviews a disclosure statement. If your campaign is seeking public matching funds, the statement review provides a list of matching claims found to be invalid and the reason. The following template letters assist campaigns in obtaining the necessary contributor information to address some invalid matching claims. For more information, refer to the Invalid Matching Claims (IMC) Codes guidance document.

Address Verification
SRC-9

Billing Address Verification
SRC-11

Contribution Affirmation
DOC-5; DOC-6; DOC-7; DOC-8; DOC-9; DOC-10; DOC-11; DOC-12; DOC-16

Contribution Affirmation—Notarization RequiredOnly if specifically requested by the CFB.

Contribution Drawn on Business Account
SRC-2

Contributor is Not an Individual
SRC-7

Contributor Under Eighteen Years of Age
SRC-6

Missing/Incomplete Employment Information
RPT-2

Missing/Incomplete Residential Information
RPT-4; SRC-10

Reported Contributor Does Not Match Backup
RPT-6