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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.