Carper - Candidate Oath - 08-24-20CANflUDA C>> ,9 LSC -1
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(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
A
- a% nd° date oath1
(Section 99.021(1)(a), Florida Statutes)
1, Ricky L. Carper
(Print name above as you wish it to 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 awrite-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 Mayor o Seat 1
(Office)
N/A 1 ; I am a qualified elector of Duva
(Circuit #) (Group or Seat #)
N/A
(District #)
County, Florida;
am qualified under the Constitution and the Laws of Florida to hold the office to which I desire to be nominated or elected;
have qualified for no other public office in the state, the term of which office or any part thereof runs concurrent with the office
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): 103610268
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.]
RICKoeo CAHRoper
7? ,,,,
Signa
it
Candidate te--------
1810 Selva Grande Dr.
( 904) 545-3125
Telephone Number
Atlantic Beach
FI
rick@ ri c kca rp e r=fo rm ayo r. co m
Email Address
32233
Address
STATE OF FLORIDA
COUNTY OF psvoll
City
Sworn to (or affirmed) and subscribed before me by b physical or
online presence this 27#1' day of 20 20 .
Personally Known: or Produced Identification:
Type of Identification Produced: N/
State ZIP Code
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Signature of Notary Public
Print, Type, or Stamp Commissioned Name of Notary Public below:
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4 � v!ett DONNA L. BARTLE
*+ MY COMMISSION # GG 078627
4� EXPIRES: May 14, 2021
���� tosele o ��,Bonded Thru Notary Public Undrerwriters
DSI,DE 302NP (Rev. 04/20)
Rule 1S=2.0001, F.A.C.