HomeMy WebLinkAboutDSDE 302NP ANDIDATE 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
RECEIVED
AUG 2 a 2021
City of Sebastian
City Clerk's Office
OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
I, �/, �n r
(Pont name above as you wish if 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 )C /Jo < i, n Ti
(Office) �`1 (District#)
I am a qualified elector of ZJ) —, /(, lr r Cv k/2 y4v County, Florida;
(Circuit#) (GmuporSeaf#) /
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 tens 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):
Phonetic spelling for audio ballot: Print name phonetically on the line below as you wish it to be pronounced on the audio
ballot as maybe used by persons with disabilities (see instructions on page 2 of this fob^): INotapp# ble to write-in candidates.]
tJo Sn /JC /isa� �eire.e.
Address
STATE OF FLORIDA [7
COUNTY OF ,LNcil0n k)i
fIze/a imo"/�0,v
Emall Address
City State ZIP Co e
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S g, Type, of Notary PllllCC!issi,,
Print, Type, or Stamp Commissioned Name of Notary Public below:
Swom to (or affirmed) and subscribed before me by means of
online nn^Lo,tarrization ❑ OR physical presence 0-
this ( day of)/�( T ,2oQ-L
Personally Known LJ OR Produced Identification ❑
Type of Identification Produced -
,n CATHERINE E TESTA
R,.nyt;,. CommisdonaHH OSd261
E*N FAIM 152025
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DS-DE 302NP (Rev. 0512021) Rule 1S•2.0001, F.A.C.