Affidavit for Erick Bennett

Page 1

=FORM 20

.

,c.emized Campaign Finance Disclosure Statement ::;ONNECTJCUT STATE ELECTIONS ENFORCEMENT COMMISSION :1.ev.. 1/{}7

SUMMARY PAGE

o January 10 filing o April 10 filing o July 10 filing o October 10 filing

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o

7th day preceding primary

7th day preceding referendum

o Initial Contribution or Disbursement (pACsONLy)

030 days following primary

o 7th day preceding election o 12th day preceding election

o 45 days following referendum o Deficit o Terrnination

o Amendment to

(State Central Committees Only)

Type of Report:

Date Filed:

045 days following election

Beginning Date

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I hereby certify and state, under penalties of false statement, that all of the information set forth on this Itemized Campaign Finance Disclosure Statement for the period covered is true, accurate and complete.

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PRINT NAME OF SIGNER

PENALTY FOR FALSE STATEMENT IS PUNISHABLE BY FINE NOT TO EXCEED $1,000, OR IMPRISONMENT FOR NOT MORE THAN ONE fEAR, OR BOTH.


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