68B Ed Tobin 6/25/08 R5B- ~~
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FORM 8B MEMORANDUM C)F "VO~LNG CONFLICT FOi~ -
000'NTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
LAST NAME-FIRST NAME=M!DDLE'NAME " ~
®o ® ~ NAME OF BOARD, COUNCIL, COMMISSION, AUTHORITY, OR C/O~M®MITTEE
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MAILING ADDRESS
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6~ - THE BOARD, COUNCIL, COMMISSION, AU HORITY OR COMMITTEE ON
WH~I H I SERVE IS A UNIT OF: '
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000NTY ~ "TY ' O COUNTY. , O OTHER
LOCAL AGENCY
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CITY
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NAME OF POLITICAL SUBDIVISION:
DATE ON WHICH VOTE OCCURRED -
~~ ~• l~J~ _ MY POSITION IS: -
[°I ELECTIVE U APPOINTIVE -
. ~ WHO.MUST FILE FORM 8B ~ ~ -
This form is'for use by any person serving>at the county, city, or otherlocal level of government on ari~appointed or elected .board, council;
commission, authority, or.committee:. It applies equally to members of .advisory and non-advisory bodies who are presented with'a voting
conflict of interest under Section 112.3143, Florida Statutes. ~ -
Your,responsibilities under the law when faced with voting~'on a measure in which you have a conflict of interest will vary greatly dependirig
bn whether ou hold an elective or a ointive osition. Fo~~,this`reason~ lease a "'rclose attention to the instructions on this form before
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' completing'the reverse 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 office MUST ABSTAIN. from voting on a measure which
inures to. his ocher special private gain or loss, Each elected 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 government agency) by whom he or she is .retained (including the
parent organization or,subsidiary of a corporate principal by which he or she is retained); to the special private .gain or loss ofa relative; or
to the special=p~ivate gain'or loss of a .business .associate. Commissioners of community redevelopment agehcies under Sec. 163.356 or
:,163.357, F.S., and officers of independent special tax districts elected on a one-acre, one-vote basis are not prohibited from voting in that:
capacity.. -.
For:'purposes of this law, a °relative" includes only the officer's father, mother,. son, daughter, husband, wife, .brother:, sister, father-in-.law,
`mother-in,law, son-in-law, and daughter-iri-law. A "business associate" means any person or entity engaged in or carrying on a business -
enterprise"with the office. as a. partner, `joint venturer, coowner of propeity, oi' corporate shareholder (where the shares of the corporation
are ".notiisted on any national or regional stock exchange):
fLECTED.OFFICERS:
• In additionto abstaining from voting in the situations described above, you must disclose the conflict:
~,~PRIOR TO THE VOTE BEING,TAKEN, by publiclyatating to~ the assembly the nature of your interest: in the measure on which you
are abstainirig;fr mwoting; an'd~'t 4,
V~WITNIN 15~DAYS AFTER THE VOTE OCCURS by completing and filing this-focm with the. person resporisible for recording the. min-
utes of`the meeting,whoshould incorporate the form in the minutes.. -
APPOINTED OFFICERS: ~ .
.Although.°you:must abstain from. voting iri the situations described above, .you otherwise may participate in these matters. However, you
must disclose the nature of the-conflict before. making any attempt to influence the decision, whether orally or. in writing and whether made
_. bX You or at your directioh.
IF YOU INTEND TO MAKE ANY ATTEMPT TO JNFLUENCE THE DECISION PRIOR TO THE .MEETING AT WHICH THE VOTE WILL BE
TAKEN: , 4 ,
•. You must,complete and file this form {before making any attempt to influence the decision) with the person responsible for recording the ..
inutes of th t' h 'll ' t th f th t
m e mee rng, w .owl :mcorpora e e orm In a menu es. (Continued on other side)
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APPOINTED OFFICERS (continued)
• A copy of the form must be provided immediately to the other members of the agency.
• The form must be read publicly at the next meeting afterthe,form is filed.
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
• You must'di'sclose~orally the naturewof~your*cohfhct in the'measure before participating: - ~'~ ~~'~,.
• You must complete the form and file it within 15 days after the vote occurs with the:'person ~esponsibl'e fog recording the miriutes of the ;
meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the;other members of the
agency and the form must be read publicly at the next meetin(7 after ttie form,is.filed:
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DISCLOSURE OF LOCAL OFFICER'S INTER _ a, "` `'~ `~=
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1, - ~®~ ~! ~! ____~__________, hereby disclose that on ___ ~L! I~'~ ~ ~ 20 08
(a} A measure came 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 business associate, ~___~~_~___Y_~_`___y__~!__~~_ , __-____
__ inured to the special gain or loss of my relative, . '
_~ inured to the special gain or loss of __________e L~ ~_
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whom I am retained;. or ~ '
___ inured to the special gain or loss of _______~__ which
is the parent organization or subsidiary of a principal which has retained me. '
(b) The measure before my agency and the nature of my conflicting interest in the measure is as follows:
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 NOTTO'EXCEED $10,000.
CE FORM 88 -:EFF. 1/2000' PAGE 2