HomeMy WebLinkAboutDSDE302NPCandidate Oath
KE(,EJVJE70
(Section 99.021(1)(a), Florida Statutes) Fill
ll G
/ 001 SP Av ieti� b� r(j CitYof c_. ?��•',
(Print name above as you wish it to appear on the ballot. If your last name consists of two or more narM9h4, Hon
hyphen, check box ❑ (see page 2 - Compound Last Names). No change can be made after the end of quaff e
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 S,e4 1 r l4 J
(Office) (District #)
;I am a qualified elector of 1A A tJ 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): /6/1104-13-2 t.,
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.]
L oo c� z C O -f'v /✓ b e Y C�
Slgna'{ure of Ca ldate // Telephone Number
Address city
STATE OF FLORIDA
COUNTY OF -EYIU 1 Q v\ k I VC-r
Swom to (or affirmed) and subscribed before me by meanss of
online notarization ❑ OR physical presence lJ
this i k day of 11U�f m f 20 ZZ .
Personally Known [ O�RRJI Produced Identification ❑
Type of Identification Produced:
Emall Address
6 LIIIA? 6
State ZIP Code
S'�ature of Notary Public
Pn Type, or Stamp Qrnmissioned Name of Notary Public below:
*t •e• I*
T
f INN
e d
DS-DE 302NP (Rev. 0812021) 41111111111\\\ Rule 1S-2.0001, F.A.C.