Loading...
Kelly - Candidate Oath - 8-30-22 CANDIDATE OATH - 111. TT 7 NONPARTISAN OFFICE ''' (Do not use this form if a Judicial or School Board Candidate) AUG 30 2022 Check box only if you are seeking to qualify as a write-in candidate: ....... ❑ Write-in candidate OFFICE USE ONLY Candidate Oath (Section 99.021(1)(a),Florida Statutes) 1, Caccku9 Dell (Print name above as you wish it td appear on the ballot. If your last name consists of two or more names but has no hyphen, check box ❑ (see page 2 - Compound Last Names). No change can be made after the end of qualifying. Although a write-in candidate's name is not printed on the ballot, the name must be printed above for oath purposes.) am a candidate for the nonpartisan office of f \an &,/1 C'oMm i loner; (Office) (District#) ; I am a qualified elector of b(,1 Vi. County, Florida; , H (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. Candidate's Florida Voter Registration Number(located on your voter information card): (03 L(4L1 Phonetic spelling for audio ballot: Print 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 2 of this form):[Not applicable to write-in candidates.] Q 1) ^ u — C L L-- E L X Grdzu_ L. ILL/ 6 Pei 3S' - Q44'41.6)41 Signature of Candidate Telephone Number Email Address Sy)VAA 010/14iLetadl Address City State ZIP Code STATE OF FLORIDA ,2 '1'Yi.4, J "' ‘4, Signature of Notary Public COUNTY OF D VA-- Print,Type,or Stamp Commissioned Name of Notary Public below: Sworn to(or affirmed)and subscribed before me by means of online notarization ❑ OR hysical presence LJ 4s""•• DONNA L.BARTLE this 3046day of , 20 22. : MY COMMISSION#HH 085656 EXPIRES:May 14,2025 0'. Bonded Thru Notary Public Underwriters Personally Known OR Produced Identification ❑ _ Type of Identification Produced: A)/(-} DS-DE 302NP(Rev.05/2021) Rule 1S-2.0001, F.A.C.