HomeMy WebLinkAboutDSDE 302NPCANDIDATE OATH —
NONPARTISAN OFFICE
(Do not use this form if a Judicial or School Board Candidate) C y
Check box only if you are seeking to qualify as a>ry
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write-in candidate: cer„ebas,+,�
❑ write-in candidate e
OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
i, 71) 14 W\1 A B 6 i zii ON)
(Print name above as you wish it to appear on the ballot. If your last name consists of two or more names bul 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 4 ' EjbA%MAN U-0 C6sNC I L
(Office) (Distrid #)
I am a qualified elector of 1 N tbl A (J P,\V 1i `bWT1 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 ,;lected; I
have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with he office
I seek; and 1 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): 10), 9 -� o U U ()
Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on be audio
ballot as may be used by persons with disabilities (see instructions on page 2 of this form): (Not applicable to write-in candidates.)
(gip) I_C)L
Signature of Candidate Telephone Number Email Address
'ion CoEo2ce- S-F, FL_ 4s8-
Address City Sttaatte� % ] �% �,,,,ZIIP Code
STATE OF FLORIDA L VYL�IX lNj�-^-t `ry11 a
4S'ature of Notary Public
COUNTY OF Tl Id ICZn ti%Q{�pe, or Commissioned Name of Notary Public )elow:
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Sworn to (or affirmed) and subscribed before me by l physical or Sw E civ %•�s;S�
❑ online presence this '7. day ofOfLlVlixr , 20y ts
Personally Known: V_ or Produced Identification: _ 272343
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Type of Identification Produced: 'i/���"'I • .Zing
DS-DE 302NP (Rev. 04120) �t1111111HN1�• Rule 1S-2.D001, F.A.C.