Free Exhibit - District Court of Connecticut - Connecticut

Case 3:03-cv-00674-WWE Document 35-6 Filed O2/11/2005 Page1 of 2
Exhibit 19

Case 3:03-cv—00674-WWE Document 35-6 Filed 02/11/2005 Page 2 of 2
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TOWN OF STRATFORD WB i X
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i T JAN 2 3 l998 ·
APPLICATION FOR RETIREMENT . L
PENS ION FUND
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` A Name of Employee Q déolgggf dig *
Date of Request /"~ ·’ 9)*5/ Requested Effective ‘
~ * date _of retirement » ·
Date of birth /0 Date employed by Town Z4?-’i;·;"; .'°"
Number of years service Q ~ y . _
Reason for retirement _g§;Q(,[\[é/LS{I>&` ‘
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