HomeMy WebLinkAboutDSDE 302NPCANDIDATE OATH —
NONPARTISAN OFFICE
(Do not use this form if a Judicial or School Board Candidate) Crry i
Check box only if you are seeking to qualify as a 0r1' o C/erS !�o
write-in candidate: (ebast/ G
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❑ Write-in candidate ce
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Candidate Oath
(Section 99.021(1 xa), Florida Statutes)
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(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
or oath purposes.)
am a candidate for the nonpartisan office of Seh (A� t I a� l� 1 (Zw �I I '
(office)A (District tt)
I am a qualified elector of f ICA D A `.. X V P f '�^ County, Florida;
(Circuit 9) (Group or Seat 11)
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 an your voter information card):.4" -7�/ 7 71,7
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): (Not applicable to write-in candidates.]
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Sign re of C ,date Telephone Number Email Address
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Address city State y+ / ZIP Code
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COUNTY OF �nel f ekvt tecve-r Type, or Stamp Commissioned Name of Notary Public 6elo+'c
Sworn to�t(or affirmed) and subscribed before me this ) 7'
day of /i-tcgcc$ f , 20&D.
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Personalty Kno.i. LL or Produced Identification: _
Type of Identification Produced
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DS-DE 302NP(Rev. 11I/17)-i�'Pp,•:?Yp'v !4 °' � Rule 1S-2.0001, F.A.C.