HomeMy WebLinkAboutDavid W Mountford- Candidate OathCANDIDATE OATH
NONPARTISAN OFFICE
(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
OFFICE USE ONLY
Candidate Oath
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(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 ep tyl M , S S Fy /--i£/la
(Office) (District #)
I am a qualified elector of �r4 2� 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): /0 / 412 / '9 —7
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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Signature of Candidate Telephone Number Email Address
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Address City State ZIP Code
STATE OF FLORIDA
Sig ture of Nota Public
COUNTY OF ��6 Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by means of
online notarization o��PYPOB( MONICABARROS
�, ❑ OR physical presence a •''•'' Commiasion#NH166752
this /' day of 20 * ExpiresO*W5,2025
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Personally Known El OR Produced Identification M
Type of Identification Produced: a S &C . (icou -Ai
DS-DE 302NP (Rev. 08/2021) Rule 1S-2.0001, F.A.C.