Daugherty, Jonathan- Loyalty OathCANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
Received
JUN 1 7 2013
Office of City Clerk
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
1, TocA-L D
PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLOT NAME MAYNO.T.M CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the nonpartisan office of Cor4� %S S jotter ,Sea-/— S , 1 ?! 2 ,
(office) (district #)
I am a qualified elector of 0 V Va I County, Florida;
(circuit #) (group 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.
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Sig . andidate Telephone Number Email Address Ana fa,.
go //-kscUss/4»/;LJ FL yz Z-.?
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter information card): I U 3 G 7 b d.3
* 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):
3Url.ck.-/4a..,_ OcA u key (Da.1„,- e_r---ke)
STATE OF FLORIDA
COUNTY OF O tict 1
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Sworn to (or affirmed) and subscribed before me this i -1-1,r day of Y u/VV- - , 20 /3 .
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Personally Known: or
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a.: •� ,+ MY COMMISSION N # t FF 0 FF 018392
, ..; . ;,e; EXPIRES: May 14, 2017
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', ti4 'Bonded ThruNotary Public Underwntera
Signature of Notary Public
Produced Identification: Print, Type, or Stamp Commissioned Name of Notary Public
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Type of Identification Produced: 'v / r' /�
DS -DE 25 (Rev. 5111)
Rule 1S-2.0001, F.A.C.