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MAR 1 4 2012

STATE OF CONNECTICUT
STATE ELECTIONS ENFORCEMENT COMMJSS10N
20 Trinity Street Hartford, Connecticut 06106-1628
COMPLAINT NO. 2 0 1 2 4 i

Affidavit of Complaint
I,

, am a resident of : s- J+AJL- St #=20) ,

Print Complainant's Street Address

Town/City

of flv. j~
Print Town or City Name

, State of

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and my Telephone Number is ~i.3 - 311- - 3o( '+ . I hereby allege 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:

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Signed: J G: 5 !?' l-rOath Administered By: ~---'o)\Lc V__
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I SOLEMNLY SWEAR (OR AFFIRM) THAT THE ABOVE STATEMENT IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

Dated this-ty of ~(..c.,- ,2011 at L:.'...:Cl'\ii\..~\. - ieT

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
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MY COMMISSION EXPIRES MAY 31,2014

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