82 Deede Weithorn 04/14/2010~~
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FORM 8B . MEMORANbUM OF VOTING' CONFLIC~"_FOR''
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS -
ST AME-FIRST NAME-M~pj~.E NAME NAME OF BOARp COUNCIL, COMMISSION, AUTHORITY 'OR COMMITTEE
ING ADDRESS
MAIL ,~~ , ~~ -~~, , THE BOARD,.000NCIL, COMMISSION, AUTHORITY OR COMMITTEE ON '
,WH`ICHLSERVEISAUNITOF: .-.. .•
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' COUNTY
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` y~ITY U 000NTY O OTHER LOCAL AGENCY
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CITY
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, NAME,OF LITICALSUBDIVISION: - -
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DATE ON WHICH VOTE OCCURRED ~
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• .... .~ MY POSITION IS: '
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~ ~ ELECTIVE. ^ ^ APPOINTIVE ~:•
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,- : ~ ~ ' ~ ~' WHO MfJST; FILE .FORM' 8B `•' ~., T . ,
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' This.form is for.use by any. person serving'-at the county; city; or other local level of government on .an.aPpointed or- elected board, council,.
'' , commission,: authority,`or committee. It applies equally fo members of advisory and nori-advisory bodies who are presented with a voting
, conflict of interest under'Section 112:,3.143; Florida Statutes.,. ~ • - _ :
' ^ "'-Your responsibilities:underthe aaw when faced with voting on a measure in which you have.a conflict of interest will vary greatly depending
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ont~whether you hold an elective qr appointive position:~For this reason,<please pay~c(ose.attention to 'the instructions on this;forn before
completing. the reverse side and filing the form: ~` ~ ~ ~ '- ,
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' • INSTRUCTIONS FOR .COMPLIANCE WfTH SECTfON 112.3143,-FLORIDA STATUTES
A.person'holding~elective or •appoirifive.county, muriicipal,.or other local public.~offce MUST, ABSTAIN from voting on,a measure which
> inures to`tifs~or'tier special' private gain or. loss: Each elected or'appointed.focal officer also is'prohibited from knowingly'•voting on a mea- .~
sure which inures to the pecial 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 principalby,which he or she ls.retained)R to the}speci;al?private,gain or loss of a relative; or
to the special. private.gain or loss of a business associate. Commissioners ofi commuriify redeveloprrient age ~ ties under Sec. 163.356 or
:• 163.357, F.S., and officers Ijf:independentyspecial tax districts elected on a one-acre, one-vote basis are not ,prohibited from voting in that `
capacity: ~ :.
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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, sori-in-law, ahd.,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 property,-or cgrpdrate'shareholder (where the shares of the corporation
are not listed on any national or regional stock exchange). , , '
ELECTED OFFICERS: '
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Ih-addition to abstaining from'voting in;the situations described. above,~you must disclose the conflict:
PRIOR'T'O THE VOTE BEING TAKEN by .publicly stating to the assembly the nature of your interest in the measure on which you
are;atistaining from voting; and
'WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing .and filing this'formwith the person responsible for recording the min-: .
- utes of the meeting, who should incorporate the form in the minutes. -
APPOINTED OFFICERS: ~ .. • ..
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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 conflictbefore'making any attempt to influence the decision, whether orally or in writing and whether made
by you or.at your direction:~
IF~YOU INTEND TO MAKE ANY ATTEMPT l'O .INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE
TAKEN:.... , . .
• ~ You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the
` minutes of 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 fo 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 $Y DISCUSSION AT THE MEETING:
• You must disclose orally the nature of your conflict in the measure before participating. -... f ~ ~ ~ ~~ -< ,' , " .. ,
You must complete the form and file it withih 15 days after the vote occurs with,tfie person responsif~le;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.. f r . ~ ~ £ ~~ .,
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DISCLOSURE OF LOCAL OfFICER'S {NTEREST "~' * `~
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___-- `-~+_c_=____1N__~ ~~fl(_ ~ ___, hereby disclose that on _~(f ,
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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, __
w iriured to the special gain or {oss of my relative, _ ___. --_ _-~~ s
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_ ,inured to the special. gain or Toss of-M~__°~~s1~~~Qf-~'~`~~~~__ ~G~k ~ ~ <
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whom I am retained; or
___ inured to the special gain or loss of __ _ __~-_____, v,~hich
is the parent organization or subsidiary of a principal which has retained me.
(b) The measure before my agency anii the, nature of my conflicting interest in the measure is as follows ` -
0~2. c~rP hc:~.vJ.er .~ t 5 ~ . C~i-e~ ~ ~F ..
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 FORM 8B - EFF. 1/2000
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