Candidate Oath- RojasCANDIDATE OATH —
NONPARTISAN OFFICE
)o not use this form if a Judicial or School Board Candidate)
02 -04-19 10 :31 _ -RC VD
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)
(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 jf 1''� 1144 I SUP , VILALE 0CM "&
(Office) (District #)
I am a qualified elector of _ 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
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):
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.]
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Si ture of idate Telephone Number Email Address
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Address City State ZIP Code
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STATE OF FLORIDA i ` Lk-,Q
Signature of Notary Public
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COUNTY OF I C� rYl I�C Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me this
day of_,__j'Q(j LAC4 Ljt , 20 +o� &�. LESLIE RACKL
i MY COMMISSION # GG 056758
a =o`d EXPIRES: March 13, 2021
V + o''- Bonded Thru Notary PubNc Underwriters
Identification:
Personally Known: or Produced
Type of Identification Produced:
DS -DE 302NP (Rev. 11/17) Rule 1S- 2.0001, F.A.C.