Candidate Oath
(Sections 99.021(1)(a) and (2), Florida Statutes)
I,
(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.)
am a candidate for the office of Committeeman Committeewoman
Precinct/District Number
(Not applicable to State Committeemen and State Committeewomen),
I am a qualified elector of County, Florida; I am qualified under the Constitution and the
Laws of Florida to hold the office to which I desire to be nominated or elected; and I will support the Constitution of the United
States and the Constitution of the State of Florida.
Statement of Party
(Section 99.021(1)(b), Florida Statutes)
I am a member of the
Party; I have not been a registered member of any other political
party for 365 days before the beginning of qualifying preceding the general election for which I seek to qualify; and I have paid
the assessment levied against me, if any, as a candidate for said office by the executive committee of the political party, of
which I am a member.
CANDIDATE OATH –
Committeemen and Committeewomen
Check applicable one:
Precinct Committeeman or Committeewoman
District Committeeman or Committeewoman
State Committeeman or Committeewoman
Candidate’s Florida Voter Registration Number (located on your voter information card):
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.]
)
X
(
Signature of Candidate
Telephone Number Email Address
Address City State ZIP Code
STATE OF FLORIDA
COUNTY OF
Signature of Notary Public
Print, Type, or Stamp Commissioned Name of Notary Public below:
Sworn to (or affirmed) and subscribed before me by
physical or
online presence this day of , 20 .
Personally Known: or Produced Identification:
Type of Identification Produced:
