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STATE OF CONNECTICUT MAR 1 4 2012

ENFORCEMENT COMMISSION

STATE ELECTIONS

20 Trinity Street Hartford, Connecticut o6io6-EjmSC~.:LL,' COMMJGS;CN

Affidavit of Complaint
I, Lc ~pe' l\\' , am a resident of
Print Name ofComi;ainant

Town/City

mMrNTNO. 2 0 i 2,39

i 5 Fo-V'ho' AvtPrint Complainant's Street Address

of N' t'-. \1c.).ve."" , State of


Print Town or City Name

and my Telephone Number is

(C:d'ire l-; ( \t CXs-i5


Print State & Zip Code

5D'6~'60C6dL\ . 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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I SOLEMNLY SWEAR (OR AFFIRM) THAT THE ABOVE STATEMENT is TRUE


AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
Dated this~day of N\IOJC~'r , 201A at ,5 ~;:\" e)..

Signed: ~ ~Vl

OathAdminister~ ~

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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.
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