48 Nancy Liebman 11/08/00 C7C
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FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL. AND OTHER LOCAL PUBLIC OFFICERS
LA~" NAMt,; FIRST NAME MIDDLE NAME an. C UNCIL. COMMISSION. AUTHORITY, OR COMMITTEE
L ItS/!; V '> 5W
THE BOARD. C ur ICIl.. COMMISSION, AUTHORITY, OR COMMITTEE ON
WHICH I SERVE IS A UNIT OF:
~ . . COUNTY . , OTHER LOCA~ AGENCY
NAME OF POLITICAL SUBDIVISION:
"AILING AUUK;SSLMec:{ W'
MY I'05ITION IS;
APPOINTIVE
DATE ON WHICH VOTE OC UK
WHO MUST F1L'E FORM II
This form is for use by any penon 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 10 memben of advisory and non-advisory bodies who are presented
with a voting conflict of interest under Section 112.3143. Rorida Statutes. '
Your responsibilities under the law when faced with a measure in which you have a conflict of interest will vary greatly depending
on whether you hold an elective or appointive position. For this reason. please pay close attentiolt 10 the instructions on this form
before completing the revene side and filing the form.
INSTRUCTIONS FOR COMPUANCE WITH SECTION 112.3143, FLORIDA STATUTES
ELECTED OFFICERS:
A person holding elective county, municipal. or other local public office MUST ABSTAIN from voting on a measure which inures
to his special private gain. Each local officer also is prohibited from knowingly vOling on a measure which inures 10 the special
gain of a principal (other !han a government agency) by whom he is retained.
In either case. you should disclose the conflict:
PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nalure of your interest in the measure on
which you are abstaining from voting; and
WITHIN 15 DAYS AfTER THE VOTE OCCURS by completing and riling this form with the person responsible for recording
the minutes of the meeting. who should incorporate the form in the minules.
APPOINTED OFFICERS:
A person holding appointive county. municipal. or other local public office MUST ABSTAIN from voting on a measure which
inures to his special private gain. Each local officer also is prohibited from knowingly vOling on a measure which inures to the
special gain of a principal (other than a government agency) by whom he is retained.
A person holding an appointive local office otherwise may panicipate in a mailer in which h" has a conflict 0" interest. but must
disclose the nature of the conflict before making any allemptto influence the decision by ora! or wrir:en commulicalion, whether
made by the officer or at his direction.
IF YOU INTEND TO MAKE ANY ATIEMFT TO INFLUENCE THE DECISION PRIOR TO THE \IEETING AT WHICH
THE VOTE WILL BE TAKEN:
. You should complete and file this form (before making any a!lemptto influence lhe decision) with the person@)' Ie for
recording the minutes of lhe meeting. who will incorporate the form in the minutes. (j 1{3 I
. A copy of the form should be provided immediately to lhe olher members of the agency. V'
. The form should be read publicly at the meeting prior to consideration of the maIler in which you have a conflicl of interest.
I rlH\1 "H 10.>1'"
IF YOU MAKE NO AlTEMPTTO INFLUENCE THE DECISION EXCEPT BY DIscUSsION
AT THE MEETING:
· You should disclose orally the nature of your conflict in the measure before participating.
· You should complele Ihe fonn and file il wilhin 15 days afler Ihe vole occurs wilh the person responsible for recording Ihe minules
of Ihe meeting, who should incorporale Ihe form in Ihe minules.
I,
DISCLOSURE OF LOCAL OFFICER'S 1NTEREST-W
hereby disclose lhal on r
~
,,w_:
(a) A measure came or will come before. my agency which (check one) *1:= a)
_ inured 10 my special private gain; or
_ inured 10 Ihe special gain of
c '
, by whom I am relained.
(b) The measure before my agency and Ihe nalure of my inlerest in Ihe measure is as follows:
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Signalure
NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES ~J12.317 (1985), A FAILURE TO MAKE ANY REQUIRED
DISCLOSURE CONSTITUTES GROUNDS FOR AND MAYBE 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 S5,OOO.
FORM 88 . 10.86