HomeMy WebLinkAboutDSDE302NPCANDIDATE OATH
NONPARTISAN OFFICE AC�� Rry Ian FD
(Do not use this form if a Judicial or School Board Candidate)
City of`:
write-in candidatCheck box e: you are seeking to qualify as a City Cle k,. � l ar
❑ Write-in candidate OFFICE USE ONLY
Candidate Oath
r 1` (Section 99.021(1)(a), Florida Statutes)
(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 can idate's name is not printed on the ballot, the name must be printed above for oath purposes.)
1 (y G
am a candidate for the nonpartisan office of v
(Office) (District #)
I am a qualified elector of -T—A- NA !�)-wez 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; 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):
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 torn): (N\ot ap/plicablee to write-in candidates.)
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Signature of Candidate Telephone Number Email Address
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Address city state ZIP Code
STATE OF FLORIDA �4n.Ju
^ f(� ^re of Notary f�ub IIICCOUNTY OF Tnd iQr1 Pl tfair , ype, or Stamp Commissioned Name of Notary Public below:
before me by
Sworn to (oraffirmed)subRcribedphysical presence nL_I �r;• IpH1� XL
online notarizatioationl /�
this 1 � day of rl uQ m -' . 20 Zz . �tiJMy�4 �: y
Personally Known (a OR Produced Identification ❑ * % ••• t
Type of Identilcation Producer, ZZ • a g ,�1�2"� rryy `�. QQ
DS-DE 302NP(Rev. 0812021 ' K ........ " ��` Rule 1S-2.0001, F.A.C.
CANDIDATE 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
RECEIVt_,
Atir
City of
seb City �!cr'�, a;..
OFFICE: USE ONLY
Candidate Oath
\\�- `(Section 99.021(1)(a), Florida Statutes)
I' unA�C'J SA•n� tUCICIt'ctN_lmah
(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 C}�y CDu N t� tray 1
(Office) (District #)
I am a qualified elector of�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; 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): `101_ _KW,
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 form): [Not applicable to write-in candidates.]
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x (9 (To) su-
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Signature of Candidate Telephone Number
Email Address
1k-1 4 �1a�lt, 5{ St t,��a�r,
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Address (I City
State ZIP Code
STATE OF
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FLORIDA
COUNTY OF L)� d I CiVt l V Ctr
Si ture of Notary Public
Pri t e, or St issioned Name of Notary Public below:
yp ``��\�151� 1��IAry
Sworn to (or affirmed) and subscribed before me by means of
`JF 'S •% ygglpy,
online notarization ❑ OR physical presence
this 7+' dayof t+u9uSt 202Z
_*; ••• 2*
�2t KWDY31�
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Personally Known Er OR Produced Identification LI
i�'TL�e d•O�
Ima;�'
Type of Identification Produced:
i�i��',g� 1•. SD���\\
DS-DE 302NP (Rev. 05/2021)
•nnmr' Rule 1S-2.0001, F.A.C.