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HomeMy WebLinkAboutDSDE 302NPCANDIDATE OATH RECEIVED NONPARTISAN OFFICE (Do not use this form If a Judicial or School Board Candidate) AUG 1 Check box only if you are seeking to quality as a write-in AUG 1013 candidate: City Of Sebastian Write-in candidate City Clerk's Office OFFICE USE ONLY Candidate Oath Name for Ballot: Sherrie / / Matthews t First Middle Name/lnitiallandtor/Nickname Last Name Suffix (See reverse side for Nickname Affidavit.) I swear or affirm that I am a candidate for the nonpartisan office of Sebastian City Council (Office) (District #) I am a qualified elector of Indian River County County, Florida (Circuit #) (Group or Seat #) I am a qualified elector 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 once 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 Slates and the Constitution of the State of Florida. Statement of Outstanding Fines, Fees, or Penalties owe outstanding fines, fees, or penalties, that cumulatively exceed $250, for ethics or campaign finance violations (s. 99.021(1)(d), FS.). YES, I Do NO, I Do Not X If you do, you must also specify the amount owed and each entity that levied the same on the reverse side. XV Nl (Ml.[�� l� (772 ) 473-6757 smatt06l8@comcast.net Signature o an 1 ale Telephone Number Email Address Sebastian FL 32958 Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF L110L 1 Q f% R 1V,( j Sworn to (or affirmed) and subscribed before me by means of online notarization ❑ OR physical presence this o 44, day of /b," Q uS f . 20 23. ._r Personally Known [9 OR Produced Identification ❑ Type of Identification Produced: DS-DE 302NP (Eff. 12023) W j Public Type, or MY COMMISSION EXPIRES 2-284027 Name of Notary Public below: Rule 1S-2.0001, F.A.C. Statement of Outstanding Fines, Fees, or Penalties Pursuant to Section 99.021(1)(o), F.S., each candidate, whether a party candidate, a candidate with no party affiliation, or a wdte-in candidate, shall, at the time of subscribing to the oath or affirmation, stale In writing whether he or she owes any outstanding fines, fees, or penalties that cumulatively exceed $250 for any violations of s. 8. Art. it of the State Constitution, the Code of Ethics for Public Officers and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requirements, or chapter 106. Amount N/A My legal name is Sherrie Matthews contents of this affidavit are true and correct. Enttty i �0 EGG•'8 102a �fY Of City r ` SebacAQ so kffice Affidavit of Nickname I am over the age of eighteen (18) and the My nickname is N/A . I am generally known by this nickname or have used It as part of my legal name. I have not created the nickname to mislead voters. My nickname does not Imply I am some other person, constitute a political slogan or otherwise associate me with a cause or Issue, or that is obscene or profane. Signature: J / 1 /at(.d.-w' ) STATE OF FLORIDA COUNTY OF Tn d i OL" Kt v- CY Swom to (or affirmed) and subscribed before me by means of online notarization ❑ OR physical presence Ly/ this )O4l�l-, day of Lk.q USt ,20 23. Personally Known OR Produced Identification ❑ Type of Identification Produced: DS•DE 302NP (Eff. J2023) nature of Notary P Ic Print, Ty or Stamp Commissioned Neme of Notary Public below: ON E�XP(CROES2,28.202i OF Rule 1S-2.0001, FA.C.