Page I of

AFFIDAVIT OF COMPLAINT RECEIVED

f

STATE ELECTIONS ENFORCEMENT COMMISSION

Revised July 2012 File No.: 2021-204 r

Please complete this form to the fullest WWWWWMISStol4

The followin( y sections are required and must be completed in full:
I. Identity of Complainant( s)— page 1 1 III. Violation( s) Alleged page 3 1 VI. Certification— page 6

1. IDENTITI- OF COMPLAINANTS)

COMPLAINANT' S NAME
First Name MI Last Name Suffix

Daphne Slopak

COMPLAINANT' S STREET ADDRESS

Addre„

10 N 2nd Ave

C' gc State Zip Code

Taftvile CT 06380

COMPLAINANT' S TELEPHONE NUMBER

I lomo Work Cell

860- 884- 5969 860- 884- 5969 860- 884- 5969

COMPLAINANT' S EMAIL. ADDRESS

slodaph( Dyahoo. com

COMPLAINANT' S NAME

First Nano All Last Nautc Suffix

COMPLAINANT' S STREET ADDRESS

Address W

City State Zip C de

COMPLAINANT' S TELEPHONE NUMBER

Home Work Cell

COMPLAINANT' S EMAIL ADDRESS

COMPLAINANT' S NAME
First Name MI Lust Kane SUffiY

COMPLAINANT' S STREET ADDRESS

Addres,

stale zip code

City

COMPLAINANT' S TELEPHONE NUMBER

11ome Rork Cell

COMPLAINANT' S EMAIL ADDRESS

 Page 2 orli
AFFIDAVIT OF COMPLAINT
STATE ELECTIONS ENFORCEMENT COMMISSION -
w
Revised July 2012

II. IDENTITY OF RESPONDENT( S)

RESPONDENT' S NAME ( Iflmown: othetwLse write" unlmown")

I: ir.,t Name ill last Natm Suflir

Dianne Daniels

RESPONDENT' S STREET ADDRESS (# known)

Address

unkn

Ulm irate / ip Code

RESPONDENT' S TELEPHONE NU BER ( Ifknown)

Hume k ork

860- 823- 3757

RESPONDENT' S FNIAIL ADDRESS ( 1t" ktrown) STATUTE( S) VIOLATED ( lt' lmow• n)

ddanielsc cityofnorwich. org

RESPONDENT' S NAME ( Ifknown. othenvice write" unkm wn

1= 11, 1 Name Nil Last Name Sttlli%

Cheryl Stover

RESPONDENT' S ST : ET ADDRESS ( Uknown)

ddress

UnknC-
State zip Code
City

RESPONDENT' S TELEPHONE NUMBER ( ljknown)

I Ionic Cork Cell

860- 823- 3754

RESPONDENT' S EMAIL ADDRESS ( fknown) STATUTE( S) VIOLATED Ofknown)

S o
RESPONDENT' S NAME ( Ifknown. or renvise write" unknown")
First Name MI Last Name sutlix

RESPONDENT' S STREET ADDRESS ( I( known)

Addre-

State Zip Code

Pity

RESPONDENT' S TELEPHONE NUMBER ( 1tknown)

1 Ionic Work Cell

RESPONDENT' S ENTAIL ADDRESS ( tfknovtn) STATUTE( S) VIOLATED( Ijknown)

Copy and attach paee(s)• rol- additional respondents Y'necessag.

Please check " See attached Additional Respondent List" and list the number oj'pages.

See attached Additional Respondent List rages

KumM J Puea,
AFFIDAVIT OF COMPLAINT %_` Page 3or6

STATE ELECTION' S ENFORCEMENT COMMISSION `

y
Revised July 2012

III. N' 10LATION( 5) , ALLEGED

DATE( S) OF ALLEGED VIOLATION( S)(! llnmc t)

11/ 3/ 2021

CONCISE STATEMENT OF FACTS

Please he as specific as possible with regard to time.,place, and the individual( s) taking actions or failing to act, and in de-
scribing their actions as well as other witnesses or persons involved. If applicable, please clearly refer to the names of identi-
fied respondents, witnesses, and attached evidence( e. g., See Evidentiary Attachment B.). If you have identified more than
one respondent, please identify which respondent is alleged to have committed which action and which specific alleged
violation of the statutes.

If you are unable to provide the specific identity of any witnesses in the following" Witnesses" section, please provide as
much identifying information as possible in the below" Concise Statement of Facts."

The respoildent( s) allegedly violated the law as follows:

am an election polling place Moderator. On 11/ 3/ 2021, 1 ran the polling place at Stanton School in Norwich, CT. Seeing that I

had no one in place as a republican assistant registrar, I Utiliized the only republican poll worker in my precinct. Though she was

listed as a checker by the registrars of voters, I trained her in the position, and she worked the day as my republican

assistant registrar. After the election, because she is a personal friend of mine, i was notified to come pick up our pay checks.

I picked up my paycheck, and Hope Jencks pay check as well. Upon opening Hope' s check( at her request) I discovered that she

was paid as a checker, and not an assistant registrar. I immediately caller the Registrars of Voters office to make them aware of the

error. I spoke to DianneV Daniels, who at that time told me that she did not palce MRS. Jencks in the assistant Registrar position

as she had not worked as a poll worker before, and she had not gone into the office for formal training. I stated that I personally

trained her, and she did the job, signed all documents as an assistant registrar, and should be paid as such. Dianne Daniels

then informed me that the position of republican assistant registrar had not been filled in my precinct, and was also not filled in

several" other precincts. She went on to tell me that she did not have enough republicans to work, arick several precincts ran

their polling places without tepubiican assistant registrars. Having been a Moderatuf for approximately tell years. I am very aware

Use attached pages) for additional statement offacts ifnecessarv.

Please check " See attached additional Statement of' Facts" and list the number ofpages.
1
See attached Additional Statement of Facts pages
AFFIDAVIT OF COMPLAINT
STATE ELECTIONS ENFORCEMENT COMMISSION j
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Revised. lulv 2012

ADDITIONAL STATEMENT OF FACTS

Page 2 of 2

CONCISE STATEMENT OF FACTS continued

That each precinct must have an assistant registrar from each party, and assistant registrars MUST be registered voters in the

town of Norwich. It is very upsetting to have knowledge of the fact that running an election without Assistant registrars from

each party is a violation of the law. With said knowled6i l approached the Mayor of the city of Norwich and had a meeting in his

office with him,( Peter Nystrom) and he included the City clerk Betsy Barrett in our meeting. I advised both parties of the fact that

Dianne Daniels told me directly that there were not republican assistant registrars in several precincts. I also advised both parties

that Dianne Daniels had her daughter Ariana Woody work at Ahepa polling place. Although Ariana Woddy had worked in past

elections, she moved to Maryland in January, and she is not a registered voter in the state of Connecticut. She is registered in

Maryland. This: too is a violation of the law, as all poll workers have to be registered voters in the state of Conneeticut.

was also told by Dianne Daniels that the St. Marks polling place was shut down for two hours, as there was a gas leak. This too

is a violation of the law. Each polling place has an emergency plan in place, and every moderator should know how to implement

their emergency plan, get to a safe location, and continue the voting process. NEV ER stopping the voting process!

This is especialy essential, as the votes were so close in Norwich, four candidates were seperated by 20 votes. Just a few turned

away voters could have altered the outcome of the election. Another violation is that I was allowed to run a polling place without

any training this election. J was extremely ill, and did not attend the training session, and then I was away on a cruise unitl two

days before the election, so I never went to training, but I was allowed to work as a moderator in the city' s largest precinct.

Peter Nystrom witnessed Ariana Woody working as he voted at the Ahepa polling place
AFFIDAVIT OF COMPLAINT = '
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STATE ELECTIONS ENFORCEMENT COMMISSION

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IV. WITNESSES

WITNESS' S NAME ( I known)

First Narne MI LastNante Suffix

Peter Nystrom

WITNESS' S STREET ADDRESS pfbroxn)

Address

Laurel Heights

Citv State Zip Code

Norwich Ct 06360

WITNESS' S TELEPHONE NUMBER ( Ifknown)

Home A ,, k- col

860- 608- 2165

WITNESS' S EMAIL ADDRESS ( Ifknorn)

V1' 11' NESS' S NAME dfknown)

Pint Nance Nil Last Name Suffix

WITNESS' S STREET ADDRESS ( 11 known)

Address

e itv State Zip Code

WITNESS' S TELEPHONE NUMBER f/( known)

I lame Work Cell

WITNESS' S EMAIL ADDRESS (/( known)

WITNESS' S NAME ( Ifknown)

hiret Name MI Last Kame 5LI i\

WITNESS' S STREET ADDRESS ( lfknorn)

Address

State Lip/' ode

City

WITNESS' S TELEPHONE NUMBER (/( known)

t lone Work Cell

WITNESS' S EMAIL ADDRESS ( 11-nown)

Copy and attach page(.$)foi- additional witnesses if necessary.

Please check " See attached Additional Witness List" and list the number- ofpages.
Sec attached Additional Witness List pages
hnmh.- r of I' ai.
 AFFIDAVIT OF COMPLAINT % " £ Page 5 01' 6
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STATE ELECTION' S ENFORCEMENT COMMISSION 1,'
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Revised 2012
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July
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V. EVIDENCE

ATTACHED DOCUMENTARY OR REAL EVIDENCE

Please identify each attachment by number of pages, title, author and date if applicable. Records not identified as
attachments shall not be considered a part of the complaint. Please do not provide a website listing as evidence, as this
information is subject to change. If you wish to provide Internet or other video or audio communications as evidence,
please provide a printed or electronic copy, as appropriate, and list it as an exhibit.
Under" How Acquired" please identify your source for the evidence( e. g., delivery from an individual, Internet website,
public flyer location). If the source is an individual, please identify the individual in the witness list. If the source is a
publication, such as a newspaper, please identify the publication' s name and date of the publication.

EVIDENTIARY ATTACHMENT
Dille Number of Pages

Author Date of Publication

I low Acquired Date Acquired

EVIDENTIARY ATTACHMENT

Title Number of Pages

A w hnr Date of Publication

I low. Acquired D;. I' Acquired

EVIDENTIARY ATTACHMENT
1 a I: Nunthcr a I I'..

Author Date of Publication

How Acquired Date Acquired

EVIDENTIARY ATTACHMENT
Fille Number of Pages

uth. n Date of Publication

How Acquired Date Acquired

Copy and attach page( s) for additional evidence if necessary.

Please check " See attached Additional Evidence List" and list the number ofpages.

See attached Additional Evidence List pages

N. A. 4 P.,
AFFIDAVIT OF COMPLAINT ,''"' 3`' F` 4 Page 6 of 6

STATE ELECTIONS ENFORCEM. ENT C OM IISSION

Revised Juiv 2012

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VI. CERTIFICATION

1) Each Complainant must sign a separate page and each signature must be separately certified. This
complaint will not be considered filed without the name, address, and original certified signature of
at least one Complainant. Mail or hand- deliver this complaint to:

State Elections Enforcement Commission

55 Farmington Ave
Hartford, CT 06105

2) Once filed, this complaint may not be withdrawn by the Complainant( s) except by a vote of the State
Elections Enforcement Commission.

3) I am aware that criminal penalties may be imposed upon any Complainant who, under penalty of
false statement, knowingly files a false complaint.

4) The State Elections Enforcement Commission' s investigation of a complaint is confidential unless

and until the State Elections Enforcement Commission votes to authorize an investigation of a
complaint. Until such a vote, neither the Commission nor its staff will release or confirm any
information about the complaint except upon written request of a treasurer, deputy treasurer,
chairperson or candidate affiliated with a committee that is the subject of the complaint or
preliminary investigation.

Guides to the elections laws are available at httn:/ Jwww. ct.( oN/ seec
Connecticut General Statutes are available at

CERTIFICATION

I solemnly swear ( or affirm) that the above statement is true and accurate
to the best of my knowledge and belief.

11/ 24/ 2021

CO INA T' S IGNATURF DATE( mm/ dd/ yyyy)

Sworn and subscribed before Ine on this Clk I day of N()4e-Vr D{ f 20 c

SIGNATURE Of PERSON ADMINIs' rFRiNG THE OATH NAM

TITLE OF PERSON ADMINISTERING THE OATH

9 Notary Public, State of Connectic—MA
My Commission Expires May 31, 2026

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 ofany coup: and attorneys who are Commissioners of the Superior Court of Connecticut.
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