AFFIDAVIT OF COMPLAINT
STATE ELECTIONS ENFORCEMENT COMMISSION
Revised July 2012
Page 6 of 6
COMPLAINANT’S SIGNATURE DATE (mm/dd/yyyy)
I solemnly swear (or affirm) that the above statement is true and accurate
to the best of my knowledge and belief.
SIGNATURE OF PERSON ADMINISTERING THE OATH
Sworn and subscribed before me on this day of , 20
NAME OF PERSON ADMINISTERING THE OATH (Please Print)
TITLE OF PERSON ADMINISTERING THE OATH
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.
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2) Once filed, this complaint may not be withdrawn by the Complainant(s) except by a vote of the State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
Guides to the elections laws are available at http://www.ct.gov/seec
Connecticut General Statutes are available at http://www.cga.ct.gov