17:17

RECEIVED
STATE ELECTIONS

STATE OF CONNECTICUT MAR 04 2019

STATE ELECTIONS ENFORCEMENT COMMISSI^ORCEWENT
20 Trinity Street Hartford, Connecticut 06106—1628 ~"cQMM?S51ON

Affidavit of Complaint
l
. a m a resident ofT^ LJ*.4iv
vey
Print Maine of Complainant Print Complainant's Street Address

Town/City of[-Wr4£*fJ State of C'T 0 £ I/^ ;

Print Town or City Name Print State & Zip Code

and my Telephone Number is g£ 0- ff J 6 - t^-C'f I hereby allege and assert that

Print Kane Number

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

place and time, as specified below: i

X uj^s <x^ 0S£*cX«O cUecker d ^ r i ^ A

X U>^s S^-^VXo^eJ cvt- ^>^\k«.\€.M [A '.

or . v x o f t .r K>^ ^ i ^ ^ J " " <9 ^ t n r -f * -v C € S

Xf ftro«lvi^a4-el^ <X«A
\ IA 4- o r i*\ u. $• uj
(Use attached page(s) if necessary)

I SOLEMNLY SWEAR (OR AFFIRM) THAT THE ABOVE STATEMENT IS TRUE

AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

Dated this V "3ay ofytUrclx , 2009 at Uciy-VVar A~

Signed:
Oath Administered By: ~6-

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 clerics, judges and clerks of any court, and
attorneys who are Commissioners of the Superior Court of Connecticut

Paqel