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CITY OF MIAMI BEACH OATH AFFIRMATION last updated 01242017--2017 CITY OF MIAMI BEACH OATH/AFFIRMATION STATE OF FLORIDA COUNTY OF MIAMI-DADE Before me, an officer authorized to administer oaths, personally appeared to me well known who, being sworn, says that he/she is a candidate for the office of City Commissioner (Group No. ____________ ) or Mayor for the City of Miami Beach, Florida; that he/she is a qualified elector of said City residing within the City at least one year before qualifying for City of Miami Beach elected office; that his/her legal residence is: , Miami Beach, Miami-Dade County, Florida; that he/she is qualified under the ordinances (including Miami Beach City Code Chapter 38 governing "Elections") and Charter of said City to hold such office; and that he/she has paid the required qualification fee or filed with the City Clerk a petition approving his/her candidacy signed by sufficient qualified and registered voters to constitute not less than two percent (2%) of this number of such voters as the same shall be on the date sixty (60) days prior to the first day of qualifying as a candidate for office. _______________________________________ Signature of Candidate Sworn to (or affirmed) and subscribed before me this _____ day of , 20__, by . Signature of Notary Public-State of Florida (NOTARY SEAL) Name of Notary Typed, Printed or Stamped Personally Known ______ OR Produced Identification _______ Type of Identification Produced F:\CLER\CLER\000_ELECTION\000_2017 GENERAL ELECTION\FORMS\CITY OF MIAMI BEACH OATH AFFIRMATION last updated 01242017.docx