HomeMy WebLinkAboutDSDE302NPCANDIDATE OATH
NONPARTISAN OFFICE RECENE�
(Do not use this form if a Judicial or School Board Candidate) 3 :_
Check box only if you are seeking to qualify as a City o{ Seor_
write-in candidate: Clerk',
ElCity Write-in candidate OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
L to VWLt-LlA �� • l u t_t_ tt .tom.. S
(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 7` ArS? t u J t�' r
(Office) (District #)
tJVk- t Jw ;I am a qualified elector of::C� b 1413 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): I j `' 4 131-1
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.]
X
(-'hZ) -i t3 Sbn 1
Signature of Candidatev Telephone Number
(UZ3 %JS t-ry k SU,k !A SE`,�a411"tdJ
Address city
STATE OF FLORIDA
COUNTY OF Zfidtrtr) Rlver
Sworn to (or affirmed) and subscribed before me by means of
online notarization ❑ FOR physical presence
this day of GuSIL ,20 9.
v
Personally Known ❑ OR Produced Identifcation$0
Type of Identification Produced: T tar, d Q 1J✓wer
Email Address
late ZIP Code
or---
Signat re of Notarl Public
Print, Type, or Stamp Commissioned Name of Notary Public below:
Danlel Garda
itNotary Public
State of Florida
Comm# HH134946
Expires 5/26/2025
DS-DE 302NP (Rev.0812021) 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
REEF/V��
Alfr•
Gtyof
Cjlii SEVo
OFFICE USE ONLY
Candidate Oath
(Section 99.021(1)(a), Florida Statutes)
lit(-e1,1 , C t t_t, l LA 0A j
(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 1-3- S i 1 W C t 11 (mod � v J�' L ��
(office) (District #)
ri a ; I am a qualified elector of :j_✓Lj tL-1v i2 tv'e--
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): I� `I L_ b -7 i l i
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.]
X <� Y✓
Signature of Candidate
1 `,,P�3 vs�
Address
STATE OF FLORIDA
COUNTY OF JTldl(zh RI VO'
(-1'7 Z) Alt 2 5,"' �+4 Wtio �'ov�C�AST, rvCT
Telephone Number Email Address
A-S s6 9AS-O -W :2-1
city State ZIP Code
Si n tured of Nof Pub Ic w
9 ry
Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by means of
online notarization ❑ OR physical presence
this � day of Au5usi 20 as .
Personalty Known ❑ OR Produced Ideentificraliion old
Type of Identification Produced: FLV R')R pj?i vX L(c&SC
ft Daniel Garda
Notary Public
wState of Florida
Commit HH134W
t, Expires 5/26/2025
DS-DE 302NP (Rev. 0512021) Rule 1S-2.0001, F.A.C.