Grant - Candidate Oath - 8-28-24CANDIDATE OATH
NONPARTISAN OFFICE
/RECEIVED
(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
AUG 2 8 2024
candidate:
❑Write-in candidate
OFFICE USE ONLY
Candidate Oath
Name to appear on ballot: Thomas C. Grant
Check box if two last names without hyphen. ❑ (Name cannot be changed after qualifying)
Check box if name includes nickname ❑ (For use of a nickname, you must complete the Nickname Affidavit on reverse side.)
I swear or affirm that I am a candidate for the nonpartisan office of Attantic t3eacit Commission e�r•-- 3
(Office) (District #)
3 I am a qualified elector of .Duval 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 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)(d), FS.).
YES, 1 Do NO, 1 Do Not X
If you do, you must also specify the amount owed and each entity that levied the same on the reverse side.
Fx
(904) 616-4354 tcgtmg3@hotmail.com
Signature of Candidate Telephone Number Email Address
1909 Selva Marina Dr Atlantic Beach FL 32233
Address of Legal Residence City State ZIP Code
STATE OF FLORIDA
COUNTY OF D LkUQ,
Signature of Notary Public
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 /�'(b� day of , 20 ;s:a ~• DONNA L.BARTLE
MY COMMISSION # HH 085656
Personally Known OR Produced Identification ❑ o EXPIRES: May 14, 2025
"�p �'
N / �} "' :F of Flo •, Bonded Thr. Notary Public Urnderwriters
Type of Identification Produced: t 1
DS-DE 302NP (Eff. 1011023 Rule 1S-2.0001, F.A.C.