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HomeMy WebLinkAboutDS-DE 25DS -DE 25 (Rev. 5111) Rule 1S- 2.0001, F.A.C. RE�F�V�e CANDIDATE OATH - AUK NONPARTISAN OFFICE citj,af �? 2413 City Cie sba�On 9W111- ce (Not for use by Judicial or School Board Candidates) OFFICE USE ONLY OATH OF CANDIDATE (Section 99.021, Florida Statutes) I, A Y,O-u4-1<a, . co (PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BA OT' -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING) am a candidate for the nonpartisan office of (offic) (district #f 1'u 1A Jv A ; I am a qualified elector of � , ,� �i �) N County, Florida; (circ it #�) (grou 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. X (?70 3$S - o `j, 1 Dos Signature of Can ate Telephone Number Email Address Address City State ZIP Code Candidate's Florida Voter Registration Number (located on your voter information card): I y6g6 -2-1© " Please print name phonetically on the line below as you wish it to be pronounced on the audio ballot for persons with disabilities (see instructions on page 2 of this form): STATE OF FLQR,.IDA _ COUNTY OF. l./�r� -G� Sworn to (or affirmed) and subscribed before me this day Personally Known: 1.1 or Signature of Ootary Public Produced Identification: Print, Type Stamp Commissioned Name of Notary Public SALLY A. MAI O Type of Identification Produced: ;: Commission # EE 024350 00 Expires October 5, 2014 Bonded Thru Troy Fain Insurance 800385.7019 DS -DE 25 (Rev. 5111) Rule 1S- 2.0001, F.A.C.