Free Exhibit - District Court of Connecticut - Connecticut

Case 3:03-cv-00674-WWE Document 35-9 Filed O2/11/2005 Page1 of 2
Exhibit 22

Case 3:03-cv—OO674-WWE Document 35-9 Filed O2/11/2005 Page2'of2 -
‘ TOWN OF STRATFORD
I APPLICATION FOR RETIREMENT
¤ PENSION FUND · _ . ‘
` I Name O-f Emp]Oy€€ rROna'].d Brenton I
Date of Request 5/ll/99 Requested Etfectiye 6/14/99 `
` ` ~ date_ot retirement g
Date of birth 6/]./40 ° Date employed by Town 1/20/72
-_ . Number of years service 27 years l I
Reason For retirement A work related heart & hypertension disability.
. Pursuant to Article 10.2 of the collective bargaining agreement.- - »
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} I I 7 I 3 /.€. I I
‘ Signature of Employee
l Action taken by Pension Boardi U
X
ri...._....._.........._........._....................;..._............
Date of Action U

’ Chairman, Pension Board