Oath 9/3/03RECEIVED
RECEIVED
03 SE? --3 &H 10:58
LOYALTY OATH
CITY {~LERK'S 0F~DIDATES WITH NO PARTY AFFILIATION
(Sec~c~s 876.05-876.10. Florida Statutes)
STATE OF FLORIDA Miami-Dade
03 SEPt3' /~ 10:57
COUNTY
(PLEASE PRAT)
First Name MIddl~ ~ntflal Last Name
a citizen of the State of Florida and of the United States of America .... and a candidate for public office.., do
hereby solemnly swear or affirm that I will support the Constitution of the United States and of the State of Florida.
OATH OF CANDIDATE
(~ ~9.[Z21, Ftt3iaa Statutes)
am a ~ndidate for the offi~ of
'~. I am a qualifi~ el~or of Miami-Dade ~un~, Florida.
(group)
I am a quabfi~d erector of t~e City of ~iami Beach, F[odda. I am qualified under the ordinances and Cha~er
of said City and 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 pubtic 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.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE RE. AD THE FOREGOING LOYALTY OATH AND OATH OF
CANDIDATE AND THAT THE FACTS STATED IN EACH ARE TRUE.
I~ EXPIRES: March 31,2004
SWORN TO AND SUBSCRIBED before me this~day
of ~fZ2003, Notary Name: ,g~
Notary Public, State of Florida
Commission Expires:
Personally Known:
Produced ID: Type:
$igl~tu~ of Candldat~
Mailing Addz~s
/~//L /
Fax Number
c~
Stat~
Zip Code
Date Signed
D~-OE 248 {Rev. a,'~g~