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STATE OF CONNECTICUT MAR 1 4 2012

STATE ELECTIONS ENFORCEMENT COMMl,SS,I!~N':7M'~;'i.-t:f1N
20 Trinity Street Hartford, Connecticut 06106-16ilJfORi.:i~,~_.d ~Ui'i." .....,\J

Affidavit of Complaint COMPLAINT NO.._ 2 0 124 2

1,

~ eo. ~~ , am a resident of \ vt ~~e.

Print Name of

Complainant Print Complainant's Street Address

Town/City of

ffow~cf
Print Town or City Name

, State of

c,-r i (j ~~ \5
Print State & Zip Code

and my Telephone Number is

qC 0 -q,r-O.. ~ ~ l hereby al lege and assert that

Print Phone Number

the election laws of

the State of Connecticut have been violated in the following manner,

place and time, as specified below:

-~ M~'i 1-&l- i ~or~. Au~,1 \V~

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'f ~ -n., C hi tkllin Npll~

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~\~ '/~tCl ~s ~crr aJC\ft~Cl me ~ ,nt'idfC\d me a.t.

(Use attached page(s) if

necessary) \JYvt- A \ \I~ do \"~ 6rfn ~~ ~ d d" ~

I SOLEMNLY SWEAR (OR AFFIRM) THAT THE ABOVE STATEMENT JS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
Dated this-=day of f'Q(~'" , 20Qat ~~~ef C-i,ti ~st 5

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Note: This oath may be administered by anyone authorized by Section 1-24 of

the Connecticut General Statutes, which includes notaries public; justices of the peace, town clerks and assistant town clerks, judges and clerks of any court, and attorneys who are Commissioners of the Superior Court of Connecticut.

D. P. CONLON
/liO 1/1 R l f'LBUC
MY COMMISSION EXPIRES MAY 31,2014

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