69 Ed Tobin 9/10/08 C7Fz.
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~~ ~ t ~ ~ :`: ~ •WHOMUSTFILEFORM8B_` ,-.
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This form is;for us`e-by.ariy person serviriy at•the county, city o~ other local'level~of government'on an appointed or elected board, council,,
commisslori; authority, or committee. It applies equally to members of advisorya.nd non-advisory%bodies wtio are presented with a voting
conflict of interest under Section 1.12.3143, Florida Statutes. `
Youc responsibilities under the law,when.f~ced w,ith'voting'on a measure:in which you have a'conflict of interest will vary~g[eatly depending
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' ,ori whetheryou;hol`d an1electrve°or appointive position. For this•rea'son,'please pay close attention~to the instructions oq this form before
'completing the reverse side and.filing,'the:form • : I ", ;... `; ; , , ` '~
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• INSTRUCTION ''~
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• CE FORM 8l3 -"EFF. 1/2000. ~ ,
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- ,. ,, S FOR COMPLIANCE WITH. SECTION 1.12:3143,`FLORIDA STATUTES ~ ~ ~ '.
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A person holding elective' or appointive county,. murncipal, or other •local public office: MUST.ABSTAIN from voting on a measure wfiich '
°` ; inures to his~:or her.. special private gain oraoss.=Each elected or appointed local officer also'is prohibited. from knowingly voting on a mea-
~" suYe' which inures to ,thespeciat gain or'loss of a°principal {other than~a:governmeritagency) by whom,he:or she•is retained (iricluding'-thee
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parent organization or subsidiary'of• a corporate principal by which he or she is retairied); to the'special private gairi or loss of a. relative; or
to the special private gain or loss.of a,business associate; Commissioners of,community:redevelopmerit agencies;under'Sec. 1.63.356br' <'
163:357 F.S. and officers; of independent special tax districts'elected oo~`a one'acre, one=vote basis are not prohibited from voting in than
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capacity ..
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~ For purposes of this law a°•"relative,•includes only,'lhe.officersfathar mother son;••daughter,~husband, wife'•tirother.;: sister, father in-law;
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mother m law son-in-law,fand.daiighter in-law A`busine'ss associate" mean's any person or entity'engaged in or carrying on`~a business
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` eriterprise withahe, officer`as a~partner; joint. venturer,-coowner of.pr`op'erty, or cgrpo~ate;shareFolder (wfiere the shares of the corporation •
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are not I~sted ;on, an
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-., 'national or re ional`stock'exchange). , ,, ,-,~ , ~ '
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,'; ELECTED OFFICERS. ~' ' •. ~ `
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In~addition to abstaining from ~ ~ •
_°•, vdting`in the situations descriti'etl above .you must disclose the conflict:
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PRIOR'TO THE VOTE BEING TAKEN by publicly statmg~.to the assembly the nature, of your rnterest•in the measure`on~which you
are abstammgyfrom voting;.and `` •
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' }.:WITHIN 1r5 DAYS AFTER THE~~VOTE OCCURS by completing and filing this form writh,the.person responsible for,recording the.min-, ,
,~ - utes of the meeting who should incorporate the form irf the mirutes.• ,.
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~`•; • APPOINTED O,FFICERS.;~ ' .. '~ ~ ~ " ~ .. :_. ,•. •. ~ .' r ,_
::; Altfiough you must abstain from voting m the situations descnbed~,above,•~you otheiwise,may~participate in these matters. However, you
must disclose the nature ofithe conflict before making any attempt toyinfluence the decision;~whettier'orally or in writing and'•whether made
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by'_,you or ,af your direction. _.• ~- ~ " ..
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~IF Y(~U INTEND TO fv1AKE ANY ATTEMPT TO INFLUENCE-THE DECISION PRIOR TO TME,MEETING,AT WHICH THE VOTE WILL BE '
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`TAKEN `
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Y.ou musf complete and file this form (before` making any attempt to influence the decision) with the person responsible for recording the
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minutes df the meeting, who will incorporate the'form in.the minutes..(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'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 complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes 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 meeting after the form is filed.
DISCLOSURE OF LOCAL OFFICER'S INTEREST
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1, ____________________~ ~_~a~ _____, hereby disclose that on _____
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(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, ________
___ inured to the special gain or-loss of my relative, ____________
___ inured tothe special gain orloss of___________________________________
whom I am retained; or
___ inured to the special. gain or loss of
is the parent orgahization or subsidiary of a principal which has retained me.
(b) a measure before my agency. and the nature of my conflicting interest in the measure is as follows:
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Date Filed
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which
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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 $1'0,000.
CE FORM 88 - EFF. 1!2000 PAGE 2