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To: Secretary of the State Vacancy/Appointment In Elective (State of Connecticut/Department of Administrative Services)

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(ED-638 - Vacancy in Elective Office 3/06)
Notice Under Section 9-223 (C.G.S.)
To: Secretary of the State Vacancy/Appointment In Elective Office
30 Trinity Street
P.O. Box 150470
Hartford, CT 06115-0470
Attn: Legislation & Elections Administration Division
Vacancy In Elective Office
On _________________________, the office of
(date of vacancy)
___________________________________________
was vacated due to the
___________________________________________
(manner in which vacancy occurred)
of the incumbent,
_________________________
_
_________________
(name)
___________________________________________
(party)
who was elected/appointed for a term
from: ______________________________________
to: ______________________________________
Appointment To Fill Vacancy In Elective Office
On ______________________________, pursuant to the provisions of
(date)
____________________________________________________________________________
(specific section of Connecticut General Statutes or local law under which vacancy was filled)
____________________________________________________________________________
(name)
________________________________________________ _______________________
(address) (party)
was appointed by _____________________________________________________________
(appointing authority)
to fill the vacancy in the office of _________________________________________________
vacated by __________________________________________________________________
(name of person who vacated office)
on _______________________________________
(date)
to serve until ___________________________________,
(date appointment expires)
being the date of O the next regular municipal election.
O the expiration of the term
City Mayor
Date of Filing _____________________ Town of __________________________________Town Clerk _________________________________
Borough Warden
(signature )
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To: Secretary of the State VacancyAppointment In Elective (State of ConnecticutDepartment of Administrative Services)

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Completed 13 August 2020

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