Candidate Oath- WagarCANDIDATE OATH -
NONPARTISAN OFFICE
Do not use this form if a Judicial or School Board Candidate)
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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)
I
(Print name 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 , Am4' S y eo V (dywiL '
(Office) (District #)
I am a qualified elector of Me - - Ai2 G 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
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):
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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Sig a y of Candidate Telephone Number Email Address
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Address City State ZIP Code
STATE OF FLORIDA
Signature of NotaGyt-
COUNTY OF Print, Type, or Stamp Co missioned Na a of Notary Public below:
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Sworn to or affirmed) and subscribed before me this,f�b
ry Public Stets of Florida
day of �� 20 X6'1 ely Rodriguez q.
ZVPj:'Expires ommission GG 244852 I10YL022
Personally Known: or Produced Identification: � � ��
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of
DS -DE 302NP (Rev. 11/17) Rule 1S- 2.0001, F.A.C.