77 Deede Weithorn 03/10/2010 R5H• • ,~s/~
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'FORM, ~B M~EIVIDRANDUM. OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, ANDOTHER LOCAL PUBLIC OFFICERS
LAST'NAME-FIRST tJAME-M'DDLE NAME ~ ~ NAME OF BOARD, COUNCIL, COMMISSION, AUTHORITY; OR COMMITTEE
MAILING ADDRESS
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• ~~, THE BOARD, COUNCIL; COMMISSION, AUTHORITY OR COMMITTEE ON
.WHICH 1 SERVE IS A UNIT OF: •
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CITY . ~ . >. COUNTY ; ' ~ ITY • U COUNTY ^ OTHER LOCAL AGENCY ,
~~~~ ~~ = ~„( \G~ D~ NAM~O,F P~O~LITI~CAL~ SUBDIVISION • _• ,
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DATE ON WHIC
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I V ; ~ ELECTIVE O~ APPOINTIVE
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WHO MUST FILE FORM ~8B- .
.This form is;for use by anyperson.serving at the county, city, or otFier local level of govemmenf.on an appointed or elected board, council,
commission;.authority, or committee. it applies equally to members of advisory and non-advisory bodies vrho are: presented with a ;voting
conflictrof~interest"uride~Section~1~12 3.154~3,.~Florida~Statutes.,; ~ •.> ~ ~~ ~,
Yourresponsitiilities Linderthe law when faced with voting on a measure; in whicfi you have a conl`licf of interest wiU vary greatly depending. '
on whether'you hold.an elective or appointive position. For this reason, please .pay close. attention. to the instructions on this form before
completing the reverse side and filing the form. •
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INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112:3143,;FLORIDA STATUTES .
A person holding elective;br appointiveacounty, municipal, or,other;lo,cal public office .MUST ABSTAIN from ,voting on a measure which
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:inures to his? or ier special private gain or loss: Each elected or appointed IocaL officer. also isfprohibited'fromknowingly voting on a urea-
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sure. which inures to the special gain or loss of a principal (otherthan 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.orioss of a relative;,or
to the special private gain. or loss`. of a business associate: Commissioners of community redevelopment agencies under Sea 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'daugtiter-in-law. A "business associate" means any. person or entity engaged in or carrying on a busiress
enterprise with the officer as a partner,.joint veriturer, coowner of property., or corporate shareholder~(where the shares of the corporation
,are not lisfedon~any'national o~ regional stock exchange): '
ELECTED OF,FfCERS.. ti `
In addition-to,abstaining fromvoting`in'the situations described above, you must disclosethe conflict: . '
'° -PRIOR'TO THE VOTE.BEINGTAKEN by, publicly stating to the assembly theinature of your interest inahe measure on which you
are abstairiing from voting; an, d ;; ;A,.
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WITHIN 1'5 DAYS AFTER THE. VOTE OCCURS by completing and filing this form with the person responsible for recording the min-.
utes ofithe 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 before making any atfempt to, influehce the decision,,whettier orally or in writing and whether made
by you or at'your direction.- ~ - . `
IF.,YOU INTEND TO.MAKEANY,ATTEMRT TO INFLUENCE THE DECISION PRIORTO THE MEETING AT WHICH THE VOTE WILL=BE
`TAKEN: ~ . _
• You must complete and fife this; form (before making any attempt to influence the decision) with the persoh respohsible for recording. the
minute's oflthe meeting, who will.ihcorp'orate the form in the minutes. (Continued on other side) rt
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DISCLOSURE OF LOCAL OFFICER'S INTEREST °` `'
I~- .lJC,e~ ~ _ hereby disclose that on__ ~0`~.- ~''~'~
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(a) A measure came or will come before my agency which (check one)
__ inured to my special private gain or oss; ~Q_ JJ~ ~__ ''
inured to the special gain or loss of my business associate, ~S~l.~'?t.~ply~ ~~, ~ ~> AJ~C' :- .
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___ .inured to thespecial gain or loss of my relative, _____-___-_~_
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- ___ - inuredao the special gain. or loss of______ ~ .~
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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:
Date Filed . - Signature
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~APPOlNTED OFFICERS (continued)
• A copy of the form must be provided' immediately fo the other members of the agency.
• The form must be read publicly at the next meeting: after the form is filed.
It= YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: ~, .
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• You must disclose orally the nature "of your conflicf in the measure before participating. ~' ~ ' * • -'''
• You must complete the form and file it within 15 days afterthevote occurs with the person•responsible;for;recgrdng 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#orm must be read publicly of the next meeting after the.form ispfiled, ~..I ~,,3„„s'~:~ ~ ~ -,, ¢~,~~
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NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKEpANY 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 FORM $B -:EFF.:1/2000
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