39 Simon Cruz 7/21/99 R7I
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FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
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X' C"I1Y 0 COUNTY 0 O1HER LOCAL A(;E:"lC:Y
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MY rOSITION IS:
X ELECTIVE a "Pf101~TIVE
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.advisory bodies who are presented
with a voting connict of interest under Section 112.3143. Florida Statutes.
Your, esponsibilities under the law when faced with a measure in which you have a connict of interest wiII 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 cOtllpleting 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!lin of a principal (other than a government agency) by whom he is retained.
ln 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; a,nd
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:
.. person holding appointive county. municipal. or other local public office MUST ABSTAIN from voting on a measure which
:nures to his special private gain. Each local officer also is prohibited from knowingly voting on a measure which inures to the
ipecial gain of a principal (other than a government agency) by whom he is rerained. .
-\ person holding an appointive local office otherwise may participate in a matler in which he has a connicr of interest, but must
!lsdose the nature of the conniet before making any anempc to innuence the decision by oral or \...ritten communication. whether
:lade by the officer or at his direction.
f YOU INTEND TO MAKE ANY ATTE~PT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
"HE VOTE WILL BE TAKEN:
You should complete and file this form (before making any attempt to influence the decision) with t~responSible for
recording the minutes of the meeting, who will incorporate the form in the minutes.
A copy of the form should be provided immediately to the other members of the agency. '3 q
The form should be read publicly at the meeling 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 the nature of your conflict in the measure before participating.
. You should complete rhe form and file 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.
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DISCLOSURf OF LOCAL OFFICER'S INTEREST
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. hereby disclose that on
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(a) A measure came or will come before my agency which (check one)
_ inured to my special private gain; Or . ./ .
L inured to the special gain of 4"'d-P'/c-9:;z/ II'.I/rer/
. by whom I am retained.
(b) The measure before my agency and the nature of my interest in the measure is as follows:
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Signarure
7- d-/~ 99
ce Filed
nCE: UNDER PROVISIONS OF FLORIDA STATUTES ~1l2.317 (1985), A FAILURE TO MAKE ANY REQUIRED
CLOSURE CONSTITUTES GROUNDS FOR AND MA Y BE 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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