DOMESTIC PARTNERSHIP AFFIDAVIT - Kevin Lembo
Retirement & Benefit Services Division. 55 Elm Street. Hartford, CT 06106-1775. Domestic Partnership Affidavit. CO-1049 NEW 3/2000. Section I. Employee/Retiree Identification Employee/Retiree Name (Last, First, MI) Sex M/F Employee # Social Security # Employing Agency (Active ................
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