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HomeMy WebLinkAboutDSDE 302NPCANDIDATE OATH — NONPARTISAN OFFICE (Do not use this form if a Judicial or School Board Candidate) Check box only if you are seeking to qualify as a write-in candidate: ❑ Write-in candidate C/ly Cr+iC°fSeb ©�Q P•"r � aSl! "tee OFFICE t SE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, J I I1^ ! L >-- (Print name above as you wish it to appear on the ballot. If your last name consists of two or more names bu' has no hyphen, check box ❑. (See page 2 - Compound Last Names). No change can be made after the end of glfalifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purpose s.) am a candidate for the nonpartisan office of SE, AS T )AA/ Cxi Y, C1jV 1"12,( (_ , 11 (Office) (Distric #) I am a qualified elector of 1 V (b(Nl✓ �A V F-e _ County, I lorida; (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): I ILI 6SIa `7J 2 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.] t�,� a1LL_ X@t%r&�JYN �f�t_ �lfo^ Signatu a Can�rdate Telephone Number Email Address T q` S �,SGvr&p Gt- _S,&aP,_;i lNA) i�_L 3?_ Address city State ZIP Code STATE OF FLORIDA C�CJ�[,k�'C- Si riature of Notary Public COUNTY OF LIJOARV l.tL*0- Print, Type, or Stamp Commissioned Name of Notary Public below: Sworn to (or affirmed) and subscribed before me by physical or ``\\��'. E �^.� �JOREte ❑ online presence this 24 tday of /T�LC S 1- , 2l)� � _� •2 � A ?��o��,•• Personally Known: I/ or Produced Identification: * : ••• "k IGG 272W Type of Identification Produced: i •@`� • yefN�il e^�� DS-DE 302NP (Rev. 04120) /� � �.STA'rt \`\,`I Rule 1S-2.0001, F.A.C.