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Home My WebLink AboutRing - Candidate Oath - 6-8-262026 Qualifying Checklist for Filing Officer's Use CANDIDATE NAME: JG&55 `Ctt- ul l� n RI DATE: 6/6 02 i& OFFICE: ❑ Mayor -Commissioner — Seat 1 ❑ Commissioner — Seat 4 D'Commissioner — Seat 5 INCUMBENT? l( YES ❑ NO Appointment of Campaign Treasurer (Form DS -DE 9) Filed for each treasurer/deputy treasurer Treasurer: Deputy Treasurer(s): Bank: ❑ Statement of Candidate (Form DS -DE 84 (Eff. 4/2026)) Filed ❑ Nomination Petition process met CapWdate Oath — Nonpartisan Office Q Co7r61 version of form submitted (DS -DE 302NP-E Corr. (Eff. 04/2026)) &K Under oath, name as it is to appear on the ballot Check box if you have a compound name without a hyphen (Last Name affects placement on ballot) Check box if you have a nickname AND complete affidavit on back of oath, notarized "Office" provided (Example: Mayor -Commissioner - Seat 1, Commissioner -Seat 4, etc.) V"District" should be N/A "Circuit #" should be N/A 4d ' .Group or Seat #" (1, 4, or 5 whichever relates to the office you are seeking) V PVV�d ounty of legal residence provided (Duval) check applicable box swearing that "I am not" OR "I am" a citizen of another country AND if also a citizen in another country, specify which country. 0 Acknowledgement of Outstanding Fines, Fees, or Penalties, AN es, complete detailed statement page 2. ET Candidate original signature provided (If you are acting as Notary, have them take an oath and /then have them sign) 2 Phone number, email address, and address of legal residence provided ,PL9�enue (county where oath taken) Vhysical presence or Online presence indicated Vate of notarization provided personally known or Produced identification is indicated r1 Identification type provided, if needed; otherwise use "N/A" l� Contains notary signature W:/,*,Notary stamp (with notary's name) affixed below signature Notary commission not expired when notarized (�f Phonetic Spelling of Name (not required for qualifying) Specify the amount owed for each entity if "I Do" was checked SV Affidavit of Nickname (Only required if using nickname for the ballot) must be notarized 2026 Qualifying Checklist Page 1 of 2 Name SSS f c a- Financ' Disclosure (Form 1) 2025 Form 1 submitted via electronic filing system: Receipt (incumbent) OR ❑ Form ❑ Candidate's (digital) signature provided ❑ Form is complete, including n/a when there is nothing to report on part of the form ❑ Form is complete, including attachments Election Assessment Fee (Mayor $139.62 OR Commissioner $112.43) E6ayable to the City of Atlantic Beach Check eck drawn on campaign account (Official, bank, cashier's check not acceptable) �Adrawn on bank designated on DS -DE 9 n ount paid ►3 E2 tount is not less than the qualifying fee (check written amount) ritten and numerical numbers are both filled in and are the same ❑ Check signed by ❑ treasurer, OR ❑ deputy treasurer, 'Processed payment through AB Cashier, obtained validated receipt to file as proof of payment SOE_Do�iients (not required to qualify) [B" L & A Receipt signed NOTE: F.S. 99.061 WC) The filing officer performs a ministerial function in reviewing qualifying papers. In determining whether a candidate is qualified, the filing officer shall review the qualifying papers to determine whether all items required by paragraph (a) have been properly filed and whether each item is complete on its face, including whether items that must be verified have been properly verified pursuant to s.92.525(1)(a). The filing officer may not determine whether the contents of the qualifying papers are accurate. ❑ Redact address & phone number from check and documents, if protected ❑ Redact social security numbers and PINs on tax returns, if applicable ❑ Redact routing numbers on check ❑ Scan documents ❑ Add documents to LF ❑ Send Oaths to DCSOE, Cierra Fackler at CFackler@coj.net ❑ Show as qualified on website 2026 Qualifying Checklist Page 2 of 2 CANDIDATE OATH li, RECEIVED / NONPARTISAN OFFICE JUN 1181016 (Do not use this form if a Judicial or School Board Candidate) C�6 Check box only if you are seeking to qualify as a write-in candidate: ;Zv p, M ❑ Write-in Candidate OFFICE URF ON" .Jessica Ring Name to appear on ballot: ❑ Check box if there two last hyphen. be are names without (Name cannot changed after qualifying.) ❑ if includes Check box name nickname. (To use nickname, you must complete the Affidavit of Nickname on page 2 of this form.) Commissioner swear or affirm that I am a candidate for the nonpartisan office of (Office) NA NA 5 Duval 1 am a qualified elector of County, Florida; (District #) (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. ss ar or affirm, in addition to being a citizen of the United States, that: (Check applicable box.) (1 5 1 am not a citizen of another country. ❑ 1 am a citizen of another country, specifically Statement of Legal Name Change: I have not legally changed my name through a petition pursuant to s. 68.07, F.S., during the 365- day period preceding the beginning of qualifying. (This does not apply to any change of name in proceedings for dissolution of marriage or adoption of children or based on a change of name conducted with a marriage certificate.) Statement of Outstanding Fines, Fees, or Penalties: (Check applicable box. If you do owe more than $250, you must also specify the amount owed an each entity that levied the same on page 2 of this form.) do not IV / I do owe 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. (s. 99.021(1)(d), F.S.) ( 904 ) 449 6682 Jessica.RingAB@gmail.com Sign re of Candidate Telephone Number Email Address 10-02 Begonia Street Atlantic Beach Florida 32233 Address of Legal Residence City State ZIP Code STATE OF FLORIDA COUNTY OF i' V a Signature of Officer Administering Oath Sworn to (or affirmed) and subscribed before me by means of Affix Seal Below or, if judge, provide name, title, and court (s. 92.50, FS.) online notarization ❑ OR physical presence IV'I-�. ., DONNA L. BARTLE this day of Ttkr)ii 20 � n � MY COMMISSION # HH 643519 EXPIRES: May 14, 20219 Type of Identification Produced: " .. DS-DE 302NP-E Corr. Eff. 04/2026 Emerqencv Rule 1SER26-2 F.A.C. Phonetic Spelling of Name (Not required for qualifying) Print the name phonetically on the line below as you wish your name to be pronounced on the audio ballot that may be used by persons with disabilities (see attached Guide for Phonetic Spelling). JESS ih kuh RING Detailed Statement of Outstanding Fines, Fees, or Penalties (Continued) 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 Officer Administering Oath Sworn to (or affirmed) and subscribed before me by means of Affix Seal Below or, if judge, provide name, title, and court (s. 92.50, FS.) online notarization ❑ OR physical presence ❑ this day of 20 Type of Identification Produced: DS -DE 302NP-E Corr. Eff. 04/2026 Emerqency Rule 1SER26-2 F.A.C.