Form 8B Ed Tobin - (70)/C ~~
FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER L_O_CAL PUBLIC OFFICE S
LHSI NN.tE FIRST NrFAE-hIIDDL~ ~GIE ~' ~
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NAtdE Of POLITICAL SUBDIVISION
DATE ON WHICH V
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WHO MUST FILE FORM 86
This form is for use by any person serving at the County, city, or other local level of government on an appointetl or elected board, council,
cornrnission, authority, or committee. It applies equally to members of advisory and non-advisory bodies who are presented with a voting
congiclof interest under Section 112.3143, Florida Statutes.
Your responsibilities under the law whon faced with voting on a measure in which you have a congict of interost will vary yreaUy depending
on whether you hottl an elective or appointive position. Far this reason, please pay closo attention to the instructions on this form before
cornpleling the revorso side and filing the form.
INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
A person holding elective or appointive county, municipal, or other local public officr. MUST ABSTAIN from voting on a measure which
inures to his or tier special private gain or loss. Each eleraod or appointed local officer also is prohibited from knowingly voting on a mea-
sure which inures to the special gain or loss of a principal {other than a govemmenl agency) by whom ho or she is retained (including the
paront organization or subsidiary of a corporate pdnCipal by which he or she is retainotl); to the special private gain or loss of a relative: or
to the special private gain or loss of a business associate. Commissioners of wmmunity redevelopment agencies under Sec. 163.356 or
163.357, F.S., and officors of independent special lax districts eloctetl on a one-acre, one-vote basis arc not prohibited from voting in that
capacity.
For purposes of this law, a "relative" inclutles only Ne officer's father, mother, son, daughter, husband, wile, brother, sister, father-in-law.
mother-in-law, son-in-law, arrd daughter-in-law. A "business associate" means any person or entity engaged in or carrying on a business
enterprise with the officer as a partner, joint venturer, coowner of properly, or corporate shareholder (where the shares of the corporation
aro not listed on any national or regional stock exchange).
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ELECTED OFFICERS:
In addition to abstaining from voting in the situations described above, you must disclose the conflicC
PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interost in the measure on which you
are abstaining from voting; and
WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the min-
utes o(lhe meeting, who should incorporate the form in the minutes.
APPOINTED OFFICERS:
Although you must abstain from voting in the situations described above, you otherwise may participate in these matters. However, you
must disclose the nature of the conflict bofore making any attempt to inNuence the decision, whether orally or in writing and whether made
by you or at your direction.
IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE
TAKEN:
Y'ou must wmplete and fila this form (before making any attempt to inFlUence the decision) wdh the person responsible for recording the
minutes of the meeting, who will incorporate the form in the minutes. (Continued on other side)
CE FORM 178 - EFF. 112000 PAGE 1
APPOINTED OFFICERS (continued)
• A copy of the form must be provided immediately to the other members of the agency.
• The (orm must be read publicly at the neM meeting after the form is filed.
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING.
• You must disclose orally the nature of your conflict in the measure before participating.
• You must wmplete the form and file it within 15 days after the vote occurs with the person responsible for recurd:ng the minutes of thy,
meeting, who must incorporate the form in the minutes. A copy of the form must lie provided immediately to the other members of the
agency, and the form must be read publicly at the next meeting after the form is filed.
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I, ~~ 1_~;.,~ (~% ,hereby disclose that on (L.`. -~.1-.~= 'L'- r_•, , 20 ~i
(a) A measure camp or will Come before my agency which (check one)
inured to my special private gain or loss;
inured to the special gain or loss of my relative, _ _ ;
inured to the special gain or loss of_ _ _ , by
whom 1 am retainod; or
inured to the special gain or loss of ,which
is the pamnt organization or subsidiary of a pdncipal which has retained me.
(b) The measure before my aCg~ency and the nJature of my congicting interest in the measure is as followrs/~:
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Date Filed Signature
NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE
CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT,
REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A
CIVIL PENALTY NOT TO EXCEED $10,000.
CE FORHi 88 - EFF. 1:2000 PAGE 2