43 Neisen Kasdin 7/26/00 R7F
FORM 88 MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
[l,\l E 0' ....HICH \OlE O<.Tl'RKF.D
N,\.\oIE Of- HOARU. COU."'CII.. CO,\.l.\.tISSIO~. AU] HQR-ITV. OR <:OMMll1'EE
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I ~IE HQ,\RU. CQlJ."'Cll.. COMMISSION. AUTHORITY OR COMMITTEE ON
WHICH I SERVE IS" U;\ilr OF
Ar'"IlY C COUNTy 0 Q1HER.IQC"1 A(;E~CY
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WHO MUST FILE FORM 88
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This form is for use by any person serving at rhe counry, city, or orh..r 10p~I~1 oPIl'6.i..rrrlJ;~nt on an appointed or elected board,
council. commission. authority, or committee. It applies equally to members of advisory and non.advisory bodies who are presented
with a voting connict of interest under Section 112.3143, Florida Statures.
rour ,"ponsibilities unde~ th: I~w wh~n fa~ed with a 'Peasllre. in w~i:~ y~{Qave a cOnflrct o!~erest will vary greatly depending
on whether you hold an el~"'~f or i'P,!l.Pm~il>ositlon, Fdr thIS rI!'AMn,-p'tease pay clost attenClOh to the mstructlons 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
gain of a principal (other than a government agency) by whom he is retained.
In either case. ,'ou should disclose the connicr:
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
\VITHIN 15 DAYS AFTER THE VOTE OCCURS 1:,y cumpleting and filing rhis form with the person responsible for recording
the minutes of the meeting, who should incorporate the form in the minutes.
APPOI:'IiTED OFFICERS:
.". person holding appointive county. municipal, or orher local public orrice MUST ABSTAIN from voting on a measure which
inures [0 his special private gain. Each local officer also is prohibited from knowingly voting on a measure which inures to the
;pecial gain of a principal (other than a government ,agency) by whom he is retained. " .
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A person holding an appointive local office otherwi;~m:iyparticipate in a matter in which he has a conf1il;rol;'jrl~~t, but must
disclose che nacure of the connicc before making any at~!n'p-t co innuence che decision by oral or written cominunii:a~idn. whether
:nade by rhe officer or at his direction.
iF YOU INTEND TO MAKE ANY ATTE:l.IPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
fHE VOTE WILL BE TAKEN:
. You should complete arld file this form (before making any attempt to inOuence the decision) with th@,ponSiblefor
recording the minutes of the meeting, who will incorporate the form in the minutes. L/ 3
, A copy of the form should be provided immediately to the orher members of the agency.
, The form should be read publicly at the meeting prior to consideration of the matter in which you have a conflict of interest.
')R\.I:'lB.I.41
PAGE I
IF YOU MAKE NO AITEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose orally the nature of your conflict in the measure before participating.
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. You should complete the form and fit.. ill~mill.1~C1ays after the vote occurs with the pcrson responsible for recording the minutes,
of the meeting. who should incorporale the form in the minutes. .>. I
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F LOCAL OFFICER'S INTEREST
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, hereby disclose that on
(a) A measure came or will come before my agency which (check one)
/:ured to my special privale gain~~lr
inured 10 the special gain of ~Jo\~c. ~V~
(b) The measure before my agency and the nature of my interesl in the measure is as follows:
, by whom I am retained.
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Signature
TICE: UNDER PROVISIONS OF FLORIDA STATUTES ~I12.317 (1985), 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,OOO.
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PACE 2