Conn. Gen. Stat. § 9-232c: Moderator to keep memorandum of challenge; form.

The moderator shall keep an accurate memorandum of the challenge which shall include (1) the name of the challenged voter; (2) his registry list address; (3) the reason for the challenge; (4) the name and address of the challenger; (5) pertinent facts concerning the challenge; and (6) the result of the moderator's decision. The challenged voter shall also sign such memorandum and it shall be assigned the same number as the challenged ballot.