Loading...
HomeMy WebLinkAboutDSDE302NPCANDIDATE OATH NONPARTISAN OFFICE RFcFf��o QIr,� (Do not use this form if a Judicial or School Board Candidate) Oil ` y Check box only if you are seeking to qualify as a Ord write-in candidate: Orf�n ❑ Write-in candidateGn Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, Ed Dodd OFFICE USE ONLY (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 Council Member City of Sebastian I , (Office) (Distri:t #) I am a qualified elector of Indian River (Circuit #) (Group or Seat #) County, Florida; I am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected; 1 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): 104688499 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.] —e4 _`_ ,AJ X ele�< g t i Signature of Candidate 906 S Flemina St. Address STATE OF FLORIDA COUNTY OF Ln A i ct n V,t/cr- ( 772-473-5440 Telephone Number Sebastian Florida cry _ stare Swom to (or affirmed) and subscribed before me by means of /orf online/notarization ❑ OR physical presence L=1 this ` i�� day oTff At`t MM L.20 Z2- Personally Known I OR Produced Identification LJ Type of Identification Produced: DS•DE 302NP (Rev.08/2021) eddodd62t7a_gmail.corn Email Address 32958 ZIP Code rLt�iktary c Pdnf, Type, or Stamp Commissioned Name of Notary Public below. •��V��Pnr?d o�. a �3 o Mi0 V230 Rule 1S-2.0001, F.A.C. CANDIDATE OATH - RECEIVED NONPARTISAN OFFICE ttt� (Do not use this form if a Judicial or School Board Candidate)?�Zt Check box only if you are seeking to qualify as a City City C,of C,-SeF Cbastian write-in candidate: ffC ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a), Florida Statutes) I, Ed Dodd (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 Sebastain City Council (office) (District #) I am a qualified elector of Indian River 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 elected; 1 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): 104688499 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.] Ed Dodd x 0, Signature of Candidate 906 S Fleming St. Address STATE OF FLORIDA COUNTY OF Tnd i LE_vl fC t \/ e K ( 772) 473-5440 Telephone Number Sebastian Fi City State Sworn to (or affirmed) and subscribed before me by meanss of online notarization ❑ OR physical presence I-1 this �day of,�'51k11 C ,20ZZ. l� Personally Known I � I OR Produced Identification ❑ Type of Identification Produced: eddodd62@gmail.com Email Address 32958 ZIP Code nature of Notary Public nt, Type, or Stamp Commissioned Name of Notary Public below: DS-DE 302NP (Rev. 05/2021) Rule 1S-2.0001, F.A.C.