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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.