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.
Conn. Gen. Stat. § 9-232c
(P.A. 75-348, S. 4, 11.)