40 Neisen Kasdin 10/20/99 C7CFORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
WHO MUST FILE FORM 8B
This Form is for use by an> ~'erson ser;'ing at the count>'. city, or other local level of government on an appoin;ed or elected board,
council. commission. authority, or committee. t app its equal v to members of advisory and non-advisory bodies who are presented
· ,,ith a ~oting conflict of interest under Section I12.3143. Florida Statutes.
~bur, :sponsibilities under the law when faced with a measure in which you have a conflict of in erest w I vary greatly depending
on whether you hold an eEoctire or appointive position. For this reason. please pay close attention to the instructions on this form
before completing the re,,erse side and filing the form.
INSTRUCTIONS FOR COMPLIANCE WITH SECTION "H2.3'14,1, FLORIDA STATUTES
ELECTED OFFICERS:
~. person holding elective county, municipal. or other local public office MUST ABSTAIN from voting on a measure which inures
o his special private gain. Each local officer also is prohibited from knowingly voting on a measure which inures to the special
:ain of a principal (other than a government agency) by whom he is retained.
n ~ither case, you should disclose the conflict:
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 DA. YS AF'TER THE VOTE OCCURS by completing and filing this Form with the person responsible for recording
the minutes of the meeting, who should incorporate the form in the minutes.
PPOINTED OFFICERS:
person holding appointive count>', municipal, or other local public office MUST ABS'EAIN from voting on a measure which
ores to his special private gain. Each local officer also is prohibited from knowingly voting on a measure which inures to the
eciai 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 matter in which he has a conflict of interest. but must
~c[ose the nature of the conflit: before making any attempt to influence the decision by oral or written communication, whether
~de by the officer or at his direction.
YOU INTEND TO MAKE ANY ATTEMFT TO iNFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
'[.E VOTE WILL BE TAKEN:
:bu should complete and file this form (before making any attempt to influence the decision with the~onsible for
.~cording the minutes or the meeting, who will incorporate the form in the minutes.
, copy or the form should be provided immediately to the other members of the agency.
'he form should be read publicly at the meeting prior to consideration of the matter in which you have a conflict of interest.
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.
· You should complete the form and file it within 13 days after the vote occurs with the person responsible for recording the minutes
of the meeting, who should incorporate the form in the minutes.
(A DISCLOSURE OF LOCAL OFFICER'S INTI:REST
I. ~ ~ ~(~ i/'. , hereby disclose that on
(a) A measure came or will come before my agency which (check one)
inured to my special private gain; or
V inured to the special gain oF ~ [~ ~C~[ ~
(b) The measure before my agency and the nature or my interest in the measure is as follows:
, by whom [ am retained,
Filed Signature
CE: UNDER PROVISIONS OF FLORIDA STATUTE5 §112.317 (1985). A FAILURE TO MAKE ANY REQUIRED
_OSURE CONSTITUTES GR. OUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING:
kCHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN
RY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED
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