Anderson, Tim J.- Candidate Oath' """"IIIA
CANDIDATE OATH —
NONPARTISAN OFFICE
(Not for use by Judicial or
School Board Candidates)
Received
JUN 1 8 2013
Office of City Clerk
OFFICE USE ONLY
OATH OF CANDIDATE
(Section 99.021, Florida Statutes)
I, Tim J.Anderson
(PLEASE PRINT NAME AS YOU WISH
am a candidate for the nonpartisan
4
IT TO APPEAR ON THE BALLOT * - NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
office of Atlantic Beach City Commission —SPA 9 , 1306, ,
(office) (district #)
; I am a qualified elector of Duval County, Florida;
(circuit #) (group or seat #)
I am qualified under the Constitution and the Laws of
elected; I have qualified for no other public office in
concurrent with the office I seek; and I have resigned
Section 99.012, Florida Statutes; and I will support the
State of Florida.
Florida to hold the office to which I desire to be nominated or
the state, the term of which office or any part thereof runs
from any office from which I am required to resign pursuant to
Constitution of the United States and the Constitution of the
tjacampaign@gmail.com
X (904 )861-5122
Signature of Candidate Telephone Number Email Address
824 Sherry Drive Atlantic Beach FL 32233
Address City State ZIP Code
Candidate's Florida Voter Registration Number (located on your voter
information card): I ObSS a6 1 q
* 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):
Tim J Anderson
STATE OF FLORIDA
COUNTY OF 1)1W a_ 1
IV‘A day of J "e' , 20 /3 .
Sworn to (or affirmed) and subscribed before me this
Personal) Known: or
Y
OrniPA DONNA L BARTLE
i ,Am .*: MY COMMISSION tl FF 018392
;�.,,
;, �� ��: EXPIRES: May 14, 2017
• R441, Bonded Thru Notary Public Underwriters
40,,,,,,_(\rAaiitee.
Signature of Notary Public
Produced Identification:
t�
Nl n
Print, Type, or Stamp Commissioned Name of Notary Public
Type of Identification Produced:
DS -DE 25 (Rev. 5111)
Rule 1S-2.0001, F.A.C.