37 Neisen Kasdin 7/2/199 C2B
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FORM 88 MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
NAME 0"- HOARD. COU~CII,.l'O.\1MJSSIO:"o. AUl HORlTY. OR COM.....IlTEE
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I HE KOARD. COUNCil.. COMMISSION. Al.:1"HORl1Y OR COMMITTEE ON
WHICH 1 SERVE IS A tJNIT OF
___ CITY C COUNTY C 01 HER LOCAl. A(lE;'IlCY
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;'l.tV POSITION IS;
.....E1.ECT1....e "0 APPOI....TIVE
WHO MUST FILE FORM 88
This form is for use by any person serving at the county. city, or other local lever 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 conflict of interest under Section 112.3143. Florida Statutes.
Your. :sponSibilities under the law when faced with a measure. in which ydJJ ha~, a conffl~t of interest will vary greatly depending
on whether you hold an elective or appointive posiCion: For this reason, pie':.se pay close att~ntion 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 a principal (other than a government agency) by whom he is retained.
In either 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 IS DAYS AFTER THE VOTE'OCCURS ~y cumpleting and filing this form with the person responsible for recording
the minutes of the meeling, who should incorporate the form in the minutes.
APPOINTED OFFICERS:
.... 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 voting on a measure which inures to the
special gain of a principal (other than a government agency) by whom he is retained.
A person holding an appoinlivelocal office otherwise may participate in a matter in which he has a conflict of interest, but must
jisclose the nature of the conniet before making any attempt (0 influence the decision by oral or writcen communication. whether
."ade by [he officer or at his direction.
I F YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING e-T WHICH
fHE VOTE WILL BE TAKEN:
. You should complete and file this form (before making any attempt to influence the decision) with the person
recording the minules 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.
, The form should be read publicly at the meeting prior [0 consideration of the matter in which you have a con
sible for
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P.~GE 1
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose or3lly che nacure of your conflict in che me3SUre before participating.
'. ..' \ .' ':...:
. You should complete the form 3nd tile it 'riChi" .1,5 days after che vOle occurs with the person respllnsible forreccirding che minutes
of the meeting. who should incorporate the form in the minutes.
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. OiSCLOSUQ'!'OFLOCAL OFFICER'S INTEREST
. hereby disclose Ih3( on -:5111 ~( 1-2.
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(al A me3sure C3me or will come before my agency which (check one)
_ inured to my special private gain: Or I
~inured Co che special g3in of Y y"q ~~
, by whom I am recained.
(b) The me3sure before my agency and che nature of my inceresC in the measure is as follows:
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re Filed
Signature
TICE: UNDER PROVISIONS OF FLORIDA STATUTES ~II2.317 (l9g5), 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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