HomeMy WebLinkAboutDSDE25CANDIDATE OATH —
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NONPARTISAN OFFICE
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9 2016
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City Cte
(Not for use by Judicial or
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School Board Can°;idates)
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
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(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT' — NAME MAY NOT BE CHANGED AFTER THE END OF OUAUFYING)
am a candidate for the nonpartisan office of c,% C."t"')
(office) (district#)
; I am a qualified elector of County, Florida;
(circuit (group or seat #)
I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or
elected; I have qualified for no other public office in the state, the term of which office or any part thereof runs
concurrent with the office I seek; and I have resigned from any office from which I am required to resign pursuant to
Section 99.012, Florida Statutes; and I will support the Constitution of the United States and the Constitution of the
State of Florida.
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Signa ure of Candidate Telephone Number Emall Address
y
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information card): I oaf& 45—
*
* Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons
with disabilities (see instructions on page 2 of this form):
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STATE OF IBAL)es+Vtg
COUNTY OF �L 1
Sworn to (or affirmed) and subscribed before me this day , 201_.
Personally Known: or /
Signa re-df Notary Public
_
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Type of Identification Produced: = Ro"a, Web
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= NunWalon, WV06701 —
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