2024 AB Candidate Qualifying PacketMEMORANDUM
TO: Candidates for Mayor - Seat 1, Commissioner - Seat 2,
and Commissioner - Seat 3
FROM: Donna L. Bartle, City Clerk
DATE: August 16, 2024
SUBJECT: 2024 AB Candidate Qualifying
Please read all of the materials in this packet very carefully. Candidates are responsible for meeting all
deadlines and correctly completing all required documents.
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Qualifying will be held from Noon, Monday, August 26, 2024 —Noon, Friday, August 30, 2024. All
qualifying requirements must be completed and received no later than Noon (EST), August 30 for a
candidate to be qualified. Our physical location and mailing address is:
Office of the City Clerk
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
WHAT TO FILE DURING THE OUALIFYING PERIOD:
1) FORM DS -DE 302NP, CANDIDATE OATH- NONPARTISAN OFFICE, and
2) FORM 1, STATEMENT OF FINANCIAL INTERESTS- 2023 (Refer to attached Memo for
further instructions.), and
• A candidate qualifying for office who is the incumbent or otherwise currently holds a
position requiring the filing of a Form 1 or Form 6 must log into EFDMS via the "I am a
Filer" button, electronically file their disclosure form, and bring in receipt of the filing.
• Non -incumbent candidates who do not otherwise hold a position requiring the filing of a
Form 1 or Form 6 must log into EFDMS via the "I am a Candidate" button, enter the
information, print their completed disclosure form and any uploaded attachments, and file the
document with the City Clerk.
3) ELECTION ASSESSMENT FEE in the amount not less than the fee required, as follows:
Mayor- Seat 1 $ 116.20
Commissioner- Seat 2 $ 70.72
Commissioner- Seat 3 .. $ 70.72
OR
AFFIDAVIT OF FINANCIAL HARDSHIP.
Additional Instructions and Reminders:
Submit original documents to the City Clerk. Exception: Form 1. (See Memo for filing instructions.)
Candidates may submit qualifying papers by hand delivery or mail. The City Clerk will not accept qualifying
papers via facsimile. All documents must have original signatures.
Notarization - Form DS -DE 302NP (and the Affidavit of Financial Hardship, if applicable) requires (sworn)
notarization. Review the document carefully and have it properly notarized. The City Clerk and Deputy
City Clerk are notaries and are available to notarize signatures when signed in their presence and with proof
of identification, if needed.
Form DS -DE 302NP:
Section: Candidate Oath:
• Type or print your name the way you wish it to appear on the ballot. A candidate's name as it
is to appear on the ballot may not be changed after qualifying. Be sure to include any necessary
punctuation.
• Determine whether you should check the box(es). Please Note: If your last name consists of
two names and has no hyphen, check the first box. If you fail to check the box, your name will be
listed with the name appearing last on the line. Example: John Jones Smith — If the last name has no
hyphen and you do not check the box, the last name on the ballot would be "Smith". If you check the
box, your last name would be listed on the ballot as "Jones Smith." If you have a hyphen within your
last name, the last name would be listed as "Jones -Smith". If you plan to use a nickname, check the
second box in this section and complete the "Affidavit of Nickname" section on the second page of
the form.
• For "Office", enter Mayor -Seat 1 or Commissioner -Seat 2 or Commissioner -Seat 3.
• For "District" and "Circuit #", enter N/A.
• For "Group or Seat #", enter either 1, 2, or 3 (whichever relates to the office you are seeking).
Section - Statement of Outstanding Fines, Fees, or Penalties:
• Check whichever box applies.
• If you answered, "Yes, I Do", you'll also need to complete the Statement of "Outstanding
Fines, Fees or Penalties" section on page 2.
Section — Signature portion:
• Provide telephone number, email address, and home address.
• Take a sworn oath administered by a notary, then sign in the notary's presence.
• The notary must complete and sign the notarization statement.
Section — Phonetic Spelling of Name:
• Provide Phonetic spelling for audio ballot. (See Guide on page 3 of Form DS -DE 302NP)
Section — Statement of Outstanding Fines, Fees or Penalties
• Complete this section if you answered "Yes, I Do" on the first page.
Section — Affidavit of Nickname:
• Complete this section only if using nickname of the ballot.
• Remember to wait and sign it in front of the notary.
Form 1, Statement of Financial Interests:
• See enclosed memo for instructions.
Memo - 2024 Qualifying Page 2 of 3
Election Assessment Fee:
• Must be paid by a properly executed check payable to the City of Atlantic Beach and drawn upon
the candidate's campaign account. If using a check (starter check) that does not have the imprint
in the upper left corner identifying it as a campaign account check — please write in the proper
information.
• The campaign check must be signed by an appointed treasurer or deputy treasurer. A check signed
by a candidate who has not been designated as the treasurer or deputy treasurer is not acceptable.
• Personal checks, cashier checks, and money orders are not accepted.
• The qualifying fee cannot be returned to a candidate unless the candidate withdraws, in writing,
before the close of qualifying.
Please Note: 99.061(7)(a)(1), Florida Statutes
... "If a candidate's check is returned by the bank for any reason, the filing officer shall immediately
notify the candidate and the candidate shall have until the end of qualifying to pay the fee with a
cashier's check purchased from funds of the campaign account. Failure to pay the fee as provided
in this subparagraph shall disqualify the candidate.
Affidavit of Financial Hardship:
• Complete an Affidavit of Financial Hardship form only if you are unable to pay the (1%) election
assessment fee pursuant to F.S. 99.093.
You will be notified by email once you have been properly qualified.
If you have any questions or require additional assistance, please contact me at (904) 247-5809, (904) 200-
9790, or at dbartle@coab.us.
ENCLOSURES:
1) FORM DS -DE 302NP, CANDIDATE OATH - NONPARTISAN OFFICE
2) MEMO REGARDING FORM 1, STATEMENT OF FINANCIAL INTERESTS
3) AFFIDAVIT OF FINANCIAL HARDSHIP
Memo - 2024 Qualifying Page 3 of 3
CANDIDATE 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:
Write-in candidate
Candidate Oath
Name to appear on ballot:
OFFICE USE ONLY.
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.)
swear or affirm that I am a candidate for the nonpartisan office of
; I am a qualified elector of
(Circuit #) (Group or Seat #)
(Office) (District #)
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)(d), F.S.).
YES, I Do NO, I Do Not
If you do, you must also specify the amount owed and each entity that levied the same on the reverse side.
x
Signature of Candidate
Telephone Number
Email Address
Address of Legal Residence City State ZIP Code
STATE OF FLORIDA
COUNTY OF 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 day of , 20 .
Personally Known ❑ OR Produced Identification ❑
Type of Identification Produced:
DS -DE 302NP (Eff. 10/2023)
Rule 1S-2.0001, F.A.C.
Phonetic Spelling of Name
Phonetic spelling for the audio ballot (not required for qualifying purposes): Print the name phonetically on the line below as you
wish it to be pronounced on the audio ballot as may be used by persons with disabilities (see instructions on page 3 of this form):
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 write-in
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 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
Entity
Affidavit of Nickname (Only required if using nickname for the ballot.)
My legal name is . I am over the age of eighteen (18) and the contents of this
affidavit are true and correct.
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 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 of Candidate:
STATE OF FLORIDA
COUNTY OF
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 day of , 20 .
Personally Known ❑ OR Produced Identification ❑
Type of Identification Produced:
DS -DE 302NP (Eff. 10/2023) Rule 1S-2.0001, F.A.C.
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 upper case for "stressed" syllables. Use lowercase for "unstressed" syllables.
3. Use dashes (-) to separate syllables.
4. Add any notes such as rhyming examples, silent letters, etc.
Vowels
Stressed Vowel Sounds Unstressed Vowel Sounds
EE (FEET) feet uh (SO-fuh) sofa (FING-guhr) finger
E
A
AH
AH
UH
UH
AW
U
00
OU
0
El
Al
01
Y00
B
D
F
G
H
HW
K
L
M
N
NG
P
(FIT) fit
(BED) bed
(KAT) cat (KAD) cad
(FAH-thur) father (PAHR) par
(HAHT) hot (TAH -dee) toddy
(FUHJ) fudge (FLUHD) flood
(CHUHRCH) church
(FAWN) fawn
(FUL) full
(FOOD) food
(FOUND) found
(FO) foe
(FEIT) fight
(FAIT) fate
(FOIL) foil
(FYOOR-ee-uhs) furious
(BED) bed
(DET) debt
(FED) fed
(GET) get
(HED) head
(WHICH) which
(JUNG) jug
(KAD) cad
(LAIM) lame
(MAT) mat
(NET) net
(SING-uhr) singer
(PET) pet
NAME ON BALLOT
Mishaud
Jahn
Beauprez
Maniscalco
Tangipahoa
Monte
Tanya
Certain Vowel Sounds with R
AHR (PAHR) par
ER
IR
OR
OOR
UHR
Consonants
R
S
T
V
Y
W
CH
SH
TS
TH
TH
ZH
Z
(PER) pair
(PIR) peer
(POR) pour
(POOR) poor
(PUHR) purr
(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 Phonetically Spelled Names
PRONOUNCED AS
mee-SHO (`d' is silent)
HAHN (rhyme: fawn)
boo-PRAI (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
Form 1— Statement of Financial Interests
Revised on 6-12-24 to reflect changes to Financial Disclosure requirements.
(Please refer to the Florida Commission on Ethics' memo dated 6-10-24 for more details.)
A candidate qualifying for office who is the incumbent or otherwise currently holds a position requiring
the filing of a Form 1 or Form 6 must log into EFDMS via the "I am a Filer" button and electronically file
their disclosure form. The law permits the filer to print and take the Verification/Receipt of Filing to their
Qualifying Officer instead of printing the disclosure form for qualifying purposes. These candidates should
make sure that the Verification/Receipt of Filing is for the appropriate disclosure form required for
qualification purposes. (Sample - Current Form 1 Filer/Incumbent Candidate—Verification/Receipt of Filing)
Non -incumbent candidates who do not otherwise hold a position requiring the filing of a Form 1 or
Form 6 must log into the EFDMS via the "I am a Candidate" button. These candidates will not file
electronically with the Commission (their form status in EFDMS will always reflect "in progress").
Importantly, because this category of candidate does not file electronically, they do not have the option to
print a Verification/Receipt of Filing. They must print their completed disclosure and any uploaded
attachments to file with the Qualifying Officer. (Sample - Non -incumbent — Form 1)
• Click the following link to access the Florida Commission on Ethics' Electronic Financial Disclosure
Management System (EFDMS) webpage for instructions and links (If you have questions on how to
fill out the information required, please contact your financial advisor.)
https: //disclosure. floridaethics.2ov/Account/Login
Please Note: Chrome, Edge, or Firefox are the recommended browsers to use for the EFDMS website.
I,
Florida Elections Commission
AFFIDAVIT OF FINANCIAL HARDSHIP
a candidate for the office of
Print Name
do hereby certify, pursuant to
Section 99.093(2), Florida Statutes, that I am unable to pay the 1% election assessment of
$ to qualify for nomination or election to public office because paying the assessment
would be an undue burden on my personal financial resources or on the financial resources available to
me. Under penalty of perjury, I declare that I have read the foregoing and that it is a true and correct
statement.
Date Signature of Candidate
Address:
City: State: Zip:
Sworn to (or affirmed) and subscribed before me this
Signature of Notary Public — State of Florida
day of , 20 by
Personally Known Produced Identification
Print, Type, or Stamp Commissioned Name of Notary Public Type of Identification Produced
Received by:
Name:
City
Telephone:
Date of Election: