42 Neisen Kasdin 6/7/00 R7C
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FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
,""l,\."1E 01-' WARO. <:OU:'.C1I.. COMMI:->:-iIQ..... AI.;l HORITY. OR CQMMlrr(E
:'>1.-\11 L"{; .\Ill>R[SS
I UE HO,\RD. COt).'OCII.. CQMMIS.'\IOi'i. AUTHORITY OR COMMITTEE ON
WHICH I SERVE IS:\ 1:;\11 r OF'
')s:'-CI1Y 0 COIJNTY C O1HE~IOCAIA(;E~CY
M'( POSITION 1:\:
~EI.EC'T\"'E a A.Pf'OI~Ti~E
WHO MUST FILE FORM 88
This form is for use by any person serving at the county, city, 6r other 10\..,,:1 level of government 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 Statutes.
'rour ,.:sponsibilities under the la,:, when faced with a measure in which you have a connict 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
gain of 3 principal (other than a government agency) by whom he is retained.
In either case, you should disclose the connict:
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 this form with the person responsible for recording
the minutes of the meeting, who should incorporate the form in the minutes.
APPOI:-iTED 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 ....oting on a measure which inures to the
5pecial gain of a principal (other than a government agency) by whom he is retained.
.-\. person holding an appointive local office otherwise may participate in a maner in which he has a conflict of interest, but",mu'sr
disclose the nature of the cannier before making any ,~ttempt to int1uence [he decision by oralor \vriuen communication, whether
:nade by the officer or at his direction.
IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
THE VOTE WILL BE TAKEN:
, You should complete and file this form (before making any attempt to innuence the decision) with the per@OSiblefor
recording the minutes of the meeting, who will incorporate the form in the minutes. I /
, A copy of the form should be provided immediately to the other members of the agency. 1;;L..
, The form should be read publicly at the meeting prior to consideration of the matter in which you have a con Ict of interest.
.)R....IICB - 141
PACE I
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose orally the nature of your confliet in the measure before participating.
. You should complele rhe form and file it wirhin 15 days after the vOte occurs with the person responsible for recording rhe minutes
of the meeting, who should incorporate the form in the minures.
M~{~Y\ KOIJ;V\
DISCLOSURE OF LOCAL OFFICER'S INTEREST
, hereby disclose lhat on ::51/1V1~ I
?at)
I.
I t9--_=
(a) A measure came or will come before my agency which (check one)
_ inured ro my special privale gain; or
L inured to the special gain of _rV\.\.. ~~u.~ ~f~ \ . by whom I am retained.
(b) The measure before my agency and the nature of my inleresr in the measure is as follows:
~l (..- T7'7V1~\q~nk~L+h t;(\t~
Av.~~~"J ~,
6 It }m
te Filed
~
Signature
nCE: UNDER PROVISIONS OF FLORIDA STATUTES ~1l2.317 (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 $5,000.
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