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47 Neisen Kasdin 10/18/00 RDA-2D FORM 88 MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS 1,\:-;1 ",,\.\IF 1<01 '-1.-\111.....(, .\DDR['SS If- l{)n I HE HOARIJ. COl).'("11.. COM....1ISSION. AlilHORll"Y OR COMM1TIEE ON WUICH I SER vE IS ..t" UNIT" OF ("IIY !It-CIlY o COU NTY o OTHER I QCAI ~c;E~CY ~ELE((I""E 0 APPOI.\iTl\.E WHO MUST FILE FORM 88 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 to members of advisory and non.ad....isory bodies who are presented with a voting cont1ict or interest under Section 112.3143, Florida Statutes. your, "sponsibilities under the law when faced with a measure in which you heve a cont1iCt of interest will 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. INSTRUCTIONS FOR COMPLIANCE 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 voting on a measure which inures to the special g.ain of a principal (other than a government agency) by whom he is retained. In either case. you should disclose the cont1ict: PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting; and WITHIN 15 DAYS AFTER THE VOTE OCCURS ~y cumpleting and filing lhis form with the person responsible for recording the minutes of the meeting, who should incorporate the form in the minutes. 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 voting on a measure \vhich inures to the special gain or a principal (other than a government agency) by whom he is retained. .-\ person holding an appointive local office otherwise may participate in a maccer in which he has a eonniet of interest, but must :iisclose the nature of the connier before making any attempno innuence the decision by oral or \.....ritten communication, whether cnade by the officer or at his direction. 'F YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH fHE VOTE WILL BE TAKEN: . You should complete and file this form (before making any allempt to int1uence the decision) with the per~o sible for recording the minutes of the meeting, who will incorporate the form in the minutes. J L1 ' A copy of the form should be provided immediately to [he other members of the agency. 7 . The form should be read publicly at the meeling prior to consideration of the mailer in which you have a c . t of interest. ,)R....1...8 - 1.91 PAGE I f ~ ~OA ~ 20 IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: . You should disclose orally the nature of your conflict in the measure before participating.,' . i !" ,I I. " . You should complete the form and tile it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who should incorporate the form in the minutes. ' , c y' 1/; ~fQ~M ~'\A , '\ ,'.' '. ;' '~ " ~I ~ . DISC,LO$URIi OF LOCAL OFFICER'S IHUrST , hereby disclose that on 10!'f6:W ')a() , +9--_: I, (a) A measure came or will come before my agency which (check one) _ inured to my special private gain; or ~ inured to the special gain of LOC? \AI '') I-J,,~ I , by whom I am retained. (b) The measure before my agency and the nature of my interest in the measure is as follows: ~ 0 - ~mxi>,1~1 (pl,v"~- ,).-1J1vV ~vv?vVV\ (;VI li\VI~\v.kJ VYl/)\tkvs' , te Filed /rJ f 11fC() l!A Signature TICE: UNDER PROVISIONS OF FLORIDA STATUTES ~1I2.317 (/9g5). A FAILURE TO MAKE ANY REQUIRED CLOSURE CONSTITUTES GROUNDS FOR AND MAYBE PUNISHED BY ONE OR MORE OF THE FOLLOWING: 'EACHMENT. REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN .ARY. REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED S5.000. IlfB-I-91 PAGE .: , \