Waters - Candidate Oath - 08-26-2011
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CANDIDATE OATH -1 c-3
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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
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AUG 2 6 2020
OFFICE. IJSE ONLY
a n 01 -) 0 a til:h
(Section 99.021(1)(a), Florida Statutes)
1, Mike Waters
(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 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 Atlantic Beach Commissioner J?a'� •.�
3 ; I am a qualified elector of Duval
(Circuit #) (Group or Seat #)
(office) (District #)
County, Florida;
I 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
1 seek; and I have resigned from any office from which 1 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 Re istration Number (located on your voter information card): 1®3723745
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.]
MEI=K WAHOTI RS
Signature of Candidate
1849 Beachside Court
Address
ST/VrE OF FLORIDA
COUNTY OF OMS V ct
( 904) 5044656
Telephone Number
Atlantic Beach
FL
drmikewaters@me.com
Email Address
32233
City
Sworn to (or affirmed) and subscribed before me by 1 `' physical or
onlineresence this 24th dayof h tic Lt s 2024
p
Personal) Known:Identification: �/
Personally o or Produced
Type of Identification Produced: Fier /CIA Dri Ver /_icenst
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State
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ZIP Code
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Signature of Notary Public
Print, Type, or Stamp Commissioned Name of Notary Public below:
,,,,*",, DONNA L. BARTLE
1 • A% a MY COMMISSION # GG 078627
liG1:' iiTo ��. o I EXPIRES: May 14, 2021
•"•\\;,oF': '% Bonded Thn> Notary Public Underwriters
DSnDE 302NP (Rev_ 04/20)
Rule 1 S-2.0001, F.A.C.