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HomeMy WebLinkAboutDS DE 320NPCANDIDATE 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: [--Iwrttean candidate RECEIVED AUG 16 2024 City of Sebastian City Clerk's Office OFFICE USE ONLY Candidate Oath Name to appear on ballot: "A,�MteV f" , `-1ILk-I t4WN5 Check box If two last names without hyphen. ❑ (Name cannot be changed attar qualifying.) Check box if name mdudes nickname. ❑ (For use of nickname, you must complete the Nickname Affidavit on reverse side.) I swear or of rrn that i am a candidate for the nonpartisan office of SE TM v l id t L (Otte) (Dishict #) ; lam a qualified elector of �A ,a rl f� t u-e �- (Circuit #) (Group or Seat N County, Florida 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 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. Statement of Outstanding Fines, Fees, or Penalties I owe outstanding fines, fees, or penalties, that cumulatively exceed $250, for ethics or campaign finance violations (s. 99.021(1)(c), F.S.J. YES, I Do � NO,1 Do Not x tf you doll6u must also specify the amount owed and each entity that levied the same on the reverse side. X t-1zl -„3 s� ►I ��I�@l anCl�t� . tJPr swwboe of Teleptrarre Nraobsr EmolAddress 1)3t_ayVL�-f'1yivc %04STrwf-f 3z45� Address of Legal Residence city Stale ZIP Code STATE OF FLORIDA COUNTYOF TJ'Idi'a i RtVe.r Sworn to (or affirmed) and subscribed before me by meansof online notarization ❑ OR physical presence L_I We �(nday of�y�� 0t5 t 20? E `{. Personally Known OR Produced Identification ❑ Type of Identification Produced: ii-; � � Ppe, or 3( IIII,Qp�nmissioned Name of Notary Public below: "�ETTE W/ ,4 'S (PRY PV d+%', MY COMMISSION EXPIRES2-28-2027 F i yr r� ��S DS-0DE 302NP (Eff.10/2023) '''a,`1,7. "N s+ Rule 1S-2.0001, F.A.C. rnonetic Spemng o'fNa �- e -- Phonetic spelling for the audio ballot (not required for qualifying purposes): Print the name phonetically on the line below as you wish 8 to be pronounced on the audio ballot as may be used by persons with disabilities (see Instructions on page 3 of this form): C//�- 41- j Statement of Outstanding Fines, Fees or Penalties Pursuant to Section 99.021(1)(d), F.S., each candidate, whether a party candidate, a candidate with no party affiliation, or a write4n candidate, shall, at the time of subscribing to the oath or affirmation, state in writing whether he or she owes any outstanding fines, fees, or penalties that cumulatively exceed $250 for any violations of s. 8, Art. II of the Stale Constitution, the Code of Ethics for Public Ofters (, and Employees under part III of chapter 112, any local ethics ordinance governing standards of conduct and disclosure requlrements, or chapter 106. Amount EntBty �U � • � �"�a,,,�rr I.{WK �i2C �o� R T ' / `% �a . Sv NS/�i .�.',� Lrd-w Affidavit of 1lickname (Only req► 40 lF Ming. nickname for the ballot.) My legal name is affidavit are true and correct - I am over the age of eighteen (18) and the contents of this My nickname Is . I am generally known by this nickname or have used It as part of my legal name. I have not created the d voters. My nickname does not Imply I am some other person, constitute a political slogan or otherwise associate me V ue, or that is obscene or profane. Signature of Candidate: STATE OF FLORIDA COUNTYOF TIA�Ctn PIver Sworn to (or affirmed) and subscribed before me by means � of online notarization ❑ OR physical presence LJ this I +� day of /'c "tQ LLS -r , 20 2-4 J Personally Known [1]� OR Produced Identification ❑ Type of Identification Produced: ra. Type, or Stamp Commissioned Name of Notary Publl: below.. .ter-^�,,,m' - m«lli ,�GS.1i &202f DS-DE 302NP (Eff.1012023) ongH 11 ,iu,m^"" Rule 1S-2.0001, FAC. DO NOT SUBMIT THIS PAGE TO THE FILING OFFICER Guide for Designating Phonetic Spelling �/,,, of Candidate's Name for Audio Ballot 1. Use the tables below. 2. Use uppercase for "stressed' syllables. Use lowercase for "unstressed'ryllables. c/ «� 3. Use dashes (-) to separate syllables. 4. Add any notes such as rhyming examples, silent letters, etc. Vowels I stressed vowel Sounds I EE (FEET)feet I (FIT) fit I E (BED) bed A (KAT) cat (KAD) cad AH (FAH-thur) father (PARR) par I AH (HAHT) hot (TAH-dee) toddy UH (FUHJ) fudge (FLUHD) flood I UH (CHUHRCH) church AW (FAWN) fawn I U (FUL) full 00 (FOOD) food ( OU (FOUND)found ( 0 (FO)foe El (FEff)fight Al (FAIT)fate OI (FOIL) foil YOO (FYOOR-ee-uhs)furious IG IH I HW IJ IK IL IM IN ( NG IP I Unstressed Vowel Sounds uh (SO-fuh) sofa (FING-guhr) finger Certain Vowel sounds with R AHR (PARR) par ER (PER)pair IR (PIRI eer OR (POR) pour OOR (POOR) poor UHR (PUHR) purr Consonants (BED) bed R (DE) debt S (FED)fed T (GET) get V (HED)head y (WHICH) which W (JUHG) jug CH (KAD)cad SH (LAIM) lame TS (MAT) mat TH (NET) net TH (SING-uhr) singer ZH (PET)pet Z I NAME ON BALLOT Mishaud Jahn I Beauprez Maniscalco I Tangipahoa I Monte Tanya (RED) red (SET)set (TEN) ten (VET) vet (YET) yet (WICH) witch (CHUCRCH)church (SHEEP)sheep (ITS) its (PITS-feeld) Pittsfield (THEI) thigh (THEI) thy (A-zhuhr) azure (VI-zhuhn) vision (GOODZ) goods( HUH-buhz-tuhn) Hubbardston Examples of Phonelocally Spelled Names PRONOYNCED AS mee-SHO ('d is silent) HAHN (rhyme: fawn) boo -PRAT (rhyme: hooray) man-uh-SKAL-ko TAN-ji-pah-HO-uh Mahn-TAI TAWN-yuh (not TAN) DO NOT SUBMIT THIS PAGE TO THE FILING OFFICER