27 Neisen Kasdin 10/2/98 R5B
/02- '8- Is:
FORM 88 MEMORANDUM OF VOTING CONFLI T FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
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N~; 0> WARD'Contm,'J1i J'AJRITY. OR COMMlIlH
I HE KOARD. COUNCIL COMMISSION. AUTHORITY OR COMMITT ~
WU? I SERVE IS A UNIT Of.":
ler'{'ITY 0 COUNTY 0 OlHER lOCAl. A(iENCY
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MY POSITION IS: 1/
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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 responsibilities under the law when faced with a measure in which you have a connict of interest will va,)' greatly depending
on whether you hold an elective or appointive position. For this reason, please pay close allention to the instructions'on this 'form
before completing the reverse side and filing the form. . " ,
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INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
ELECTED OFFICERS: "\ , , ' '_\ .
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A person holding elective county, municipal, or other local public office MUST ABSTAIN from voti~g o~ 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.
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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 I:,y completing and filing this form with the person responsible for recording
the minutes of the meeting, who should incorporate the form in the minutes.
APPOINTED 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 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 appointive local office otherwise may participate in a mailer in which he has a connict of inter~st, but must
disclose the nature of the conniet before making any attempt to inOuence the decision by oral or ,,,'rinen communication, whether
made 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) Wit€Jhn r sponsible for
recording the minutes of the meeting, who will incorporate the form in the minutes. rz... -'{
. 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 to consideration of the matter in which you have a connict of interest.
"E FORM KB- 1-91
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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 ~onn;ct, in the measure before participating. "
. You should complele the 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 ~he minut<:S., ' '\ "
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'. ,DlSCLOSURE OF LOCAL OFFICER'S INTEREST
I, /VGI5eN kM/J/N " ,hereby disclose that on O(!JlJI36fl
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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 FrW1~~ ~,
(b) The measure before my agency and the nature of my interest in the measure is as follows:
, by whom I am retained.
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Date Filed
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NOTICE; UNDER PROVISIONS OF FLORIDA STATUTES ~1l2.317 (1985), A FAILURE TO MAKE ANY REQUIRED
DISCLOSURE CONSTITUTES GROUNDS FOR AND MAYBE PUNISHED BY ONE OR MORE OF THE FOLLOWING:
IMPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN
SALARY, REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED 55,000.
; FORM 118-1-91
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