HomeMy WebLinkAboutDSDE 302NP ANDIDATE OATH —
NONPARTISAN OFFICE RECEIVED
(Do not use this form if a Judicial or School Board Candidate) AU6 14 ziJ20
Check write-in box one.
lif you are seeking to qualify as a City Of
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O
❑ Write-in candidate
OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
(Print name above as you wish it to appear on the ballot. If your last name consists of two or more names but has no
hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of qualifying.
Although a write-in candidate's name is not printed on the,ballot, the name must be printed above for oath purposes.)
am a candidate for the nonpartisan office of 6Vr-I Ce) vN G ( L
(office) (District #J
I am a qualified elector ofCounty, 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.
Candidate's Florida Voter Registration Number (located on your voter information card): t 0 11 (P 1 � Q � -I
Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio
ballot as may be used by persons with disabilities (see instructions on page 2 of this form): [Nat applicable to write-in candidates.]
Signature of Candidate Telephone Number Email Address
9'%4:0� CISiLM ME �T� �� ��-U
Address City State Jf ZIP Code
STATE OF FLORIDA W
l ature of NotaryPub i�c
COUNTY OF.�dt Qrl kl Ver P t, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and /suuIbscribed before me by physical or
El online presence this 1`r+l't day of /qt, 116 t 20Z6.
Personally Known: / or Produced identification:
Type of Identification Produced:
DS-DE 302NP (Rev. 04/20)
Rule 1S-2.0001, F.A.C.