HomeMy WebLinkAbout2018 1 - Affidavit of Residency - City & District For 3 Rev 2018 08 09CITY OF WINTER SPRINGS, FLORIDA
2018 GENERAL MUNICIPAL ELECTION
AFFIDAVIT OF QUALIFIED VOTER STATUS AND
CITY AND DISTRICT RESIDENCY
Circle As It Applies To Candidacy
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
FOR OFFICE USE ONLY
I,
of Winter Springs'
be held in the City of Winter Springs, Florida, on Tuesday, November 6, 2018. I, further swear or affirm:
(1)
(2)
(3)
(4)
(5)
Signature
Street Address City
State Zip Code
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this
by
(Print Name of Person Making Statement)
Type of Identification Produced:
Revised 8/9/2018
Name of Candidate (Please Print or Type)
I am a qualified Voter of the City of Winter Springs
My legal place of residence is:
Length of time of residency in the City of Winter Springs is:
Length of time of residency in Winter Springs District
I am attaching two (2) documents, one to be a Florida Driver's License, as verification of my residency in the
City of Winter Springs. The second document is:
Copy of Florida Driver's License provided for item (5)
Other Documentation ___________________________________ provided for item (5)
Circle As It Applies To Candidacy
City Commission: District Three
CITY COMMISSION:
(Print/Type or Stamp Commissioned Name of Notary Public)
Street Address City State Zip Code
Personally Known:
do hereby state that I seek election to the City
day of
DISTRICT THREE
Signature of Notary Public - State of Florida
- a two (2) year term, in the Election to
Date
OR Produced Identification:
is:
, 2018