Candidate Oath BellinsonCANDIDATE OATH
NONPARTISAN OFFICE
02-06-23P c,::
(Do not use this form if a Judicial or School Board Candidate)
02-06-23P 05
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, Andrew (Andy) Bellinson
(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 0 (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 Council Member
(Office) (District #)
I am a qualified elector of Mlaml-Dade 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;
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): 109448893
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.]
Andrew (Andy) Bell in son
X l -J (305) 898-0909 AndyBellinson@icloud.com
Signature of Cand€date Telephone Number Email Address
9205 NE 4th Avenue Miami Shores FL
Address City State "4.
' •¢ Notary Pubic • 5 a egji Florida
_
',� Commission N GG 292525
OT,` My Comm. Expires Mar 45, 2023
STATE OF FLORIDA �
Sign t a a u Itc
COUNTY OF QYL� ` s C i'L Print, Yfw, or StarnWommissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by means of
online notarization ❑ OR physical presence
r T^�� y • � MIGOR E. KIDD BARALT
this L �-.dayof— "_-)C VCiTj 202 �•Notary Public State of Florida
Commission N GG 292525
Personally Known '?.
❑ OR Produced Identification My Comm. Expires Mar 15, 2023
Type of Identification Produced:, L�
DS-DE 302NP (Rev. 08/2021) Rule 1S-2.0001, F.A.C.