41 Neisen Kasdin 12/15/99 R5C
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FORM 88 MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
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WHO MUST FILE FORM 88
This form is for use by any person serving at the: county, cicy, or other local level of governm~:1c on an appoinred or elected board,
<.:our:...:il. commission. authority, or committee. It applies equally to members of advisory and ncn-advisory bodies who are presented
wieh a 'oting con tli.:t of in"rest under Section 112.3143, Florida Statutes.
'your, :sponsibilieies under the law when faced wieh a measure in which you ha'e a conflict of interest will vary greaely depending
on whether )'OU hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form
before con:tpkting the reverse side and filing the form.
INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
ELECTED OFFICERS:
>. person holding elective county, municipal. or ocher local public office MUST ABSTAIN from voting on a measure which inures
:0 his special privaee gain. Each local officer also is prohibieed from knowingly voting on a measure which inures to the special
,ain of a principal (other ehan a government agency) by whom he is retained.
n either case. you should disclose the conflict:
PRIOR TO THE VOTE BEING T.>.KEN by publicly stating to ehe assembly the nature of )'our interese in the measure on
which you are abstaining from voting; and
WITHIN 15 DAYS AFTER THE VOTE OCCURS l;y cumpleting and filing this form wieh the person responsible for recording
the minutes of the meeting. who should incorporate the form in the minutes.
,PPOI.'iTED OFFICERS:
, person holding appointive county. municipal. or ocher local public office MUST ABST.>.IN from voting on a measure which
lures to his special private gain. Each Jocal of ricer also is prohibited from knowingly vodng on a mea5iJ:"e which inures to the
]ecial gain of a principal (other than a government agency) by whom he is retained.
person holding an appointive local ofrice otherwise may participate in a maner in which h-: has a connicr ofinteresr, but must
:s.:lose rhe nature of {he cannier before making any aHempt co innuence [he decision by oral or wiiuen communication, whether
ade by the officer or at his direction,
: YOU INTEND TO :VIAKE ANY ATTE\IPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
'-lE VOTE WILL BE TAKE:":
'rau should complete and file chis form (before making any actempt to influence ehe decision) WC1JJ.t' perron sponsible for
,ecording the minutes of the meeting, who will incorporate the form in the minutes. lJ {
-\ copy of the form should be provided immediately to the other members of the agency. 7
rhe form should be read publicly at the meeting prior to consideration of the matter in which you have a conflict of interest.
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IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose orally [he nature of your contlict in [he measure before participating.
. You should complererhe form and lik it within 15 days after [he vote occurs with the person responsible for recording the minutes
of the meeting. who should incorporate the form in the minutes.
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DISCLOSURE OF LOCAL OFFICER'S INTEREST
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, hereby disclose rhat on
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(a) A measure came or will come bero<< my agency which (check one)
_ inured to my special privace gain; or
.j inured to the special gain of ~.-;lIIc;?,l 0+ k,'l ~{ (l.,~
(b) The meaSUre before my agency and che nature of my interest in the measure is as follows:
, by whom I am retained.
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Filed
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Signature
ICE: UNDER PROVISIONS OF FLORIDA STATUTES ~112.311 (1985), A FAILURE TO MAKE ANY REQUIRED
LOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING:
:ACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOn..rENT. DE~IOT[ON, REDUCTION IN
.RY, REPRl."IAND, OR A CIVIL PENALTY NOT TO EXCEED S5,000.
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