HomeMy Public PortalAboutAffidavit of NicknameCITY OF
ORLANDO
ELECTIONS
Affidavit of Nickname
Affidavit of Nickname
STATE OF FLORIDA
COUNTY OF ORANGE
BEFORE ME, the undersigned, personally ppeared:
(write legal name of candidate)
who being first duty sworn or placed under affirmation says:
1. My legal name is:
I am over the age of eighteen (18) and the cdntents of this affidavit are true and correct.
2. I am a candidate of the office of: //I/% y S' >, /7 12-E_ 1) 1577194-7
3. My nickname is:
I am generally known by this nickname or have used it as part of my legal name. I have not created the nickname
to mislead voters. I plan to designate this nickname on my candidate oath as the same name I wish to have printed
on the ballot when I submit the candidate oath form during the qualifying period for the above office.
4. Attached are documents that show that my nickname is one by which I am generally known or one that I have used
as a part of my legal name. [List the title of any documents or affidavits from other persons reflecting that the
candidate is generally known by the nickname or that it has been used as part of the candidate's legal name.]
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Printed / Typed Name of Affiant
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Signature of Affiant
Swwo''rn to and subscribed before me by means of H physical presence or I 1 online notarization, this 2 / day of
, 20/. / , by W 1 u-( ftv( /M 00 It who is 1 I personally known
or n produced identification: L bRAO ��. 5 (,( C7V5
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Printed Name
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My Commission Expires
ORL-ELE FORM: AN (Rev. 06/21)
https://files.floridados.gov/media/694106/memo-nickname-on-ballot.pdf