Loyalty Oath/Oath of Candidate LOYALTY OATH
CANDIDATES WITH NO PARTY AFFILIATION
(Sections 876.05-876.1 o, Florida Statutes)
OFFICE USE ONLY
STATE OF FLORIDA
Miami-Dade
COUNTY
Fi~t Name Middle Name/Initial Last N,~r~e
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
(Section 99.021, Florida Statutes)
(PLEASE PRINT NAME AS YOU WISH IT TO APPEAR ON THE BALLkOT -- NAME MAY NOT BE CHANGED AFTER THE END OF QUALIFYING)
am a candidate for the office of ('~/,,~,,97_/~.,.9~/~,.¢.~., , N/A , N/A
(office) (district) (circuit)
~ lam a qualified elector of .~,/~" County, Florida.
(group) - -
am a qualified elector of the City of Miami Beach, Florida, residing within the City at least one year before qualifying
for City of Miami Beach elected office, with my legal residence being:.,['7.C~, ~__~-,~'~//__£-~'/~-¢. ,/~?,)~-.~ ,
Miami Beach, Florida. I am qualified under the ordinances and Charter of said City and unSer 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
)ffice from which I am required to resiqn pursuant to Section gg.012, Florida Statutes.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING LoYALTy OATH AND OATH OF
CANDIDATE AND THAT THE FACTS STATED IN EACH ARE TRUE.
SWORN TO AND SUBSCRIBED before me this ~:~ ~/~' d
~ ay
of~eeh,,,/~u~ 2005, Notary Name: ~-cbe~rT' E ~r~el-/~
Notary PubJic, ~State of Florida
Commission Expires: q/7/~6 PersonatN '
Produced ID: /V/~ Type: /V/~ ' Known':--
SIGN HERE
.~g~ature of Candidate