24 David Dermer 6/17/98 R7G
"/17/91 ;Z-/6.
FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
I :\SI .',\.\11' !-II(S I '.\.\11 ~1IJ)1l1 F ~AMF
NAME 0'" WARD. COUI'iCII~ COMMISSION, AUl HOR1TY. OR COMMIl1'EE
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IM,'t;. CofI
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ClI Y
COt) ~TY
I tiE HOARD. CDUNCI" MMISSION. AUTHORITY OR COMMlTIEE ON
WHICH I SER VE IS A (J~IT OF:
ell y 0 COUNTY C 01 HER I.OCAI. AGENCY
NAME OF POUTICAI. SUI:JDIVISION:
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MY POSITION IS:.......... _
"'-il ELECTIVE 0 APPOI~TI'.E
WHO MUST FILE FORM 88
This form is for use by any person serving at lhe coumy, city, or olher local level of government on an appoimed or e1ecled board,
council, commission, aUlhorilY. or committee. It applies equally to members of advisory and non-advisory bodies who are presemed
with a voting connict of imerest under Section 112.3143, Florida Stalutes.
Your . ~sponsibililies !lnder the law. when faced with a measure in which you have a conflicl of interesl will vary greatly depending
on whelher you hold' an eleclive or appoimive posilion. For this reason, please pay close attemion to lhe instruclions on this form
before compleling lhe reverse side and filing lhe form.
INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
ELECTED OFFICERS:
A person holding elective coumy, municipal, or olher local public office MUST ABSTAIN from voling on a measure which inures
10 his special privale gain. Each local officer also is prohibiled from knowingly voting on a measure which inures to the special
g!,in of a principal (other than a government agency) by whom he is retained.
In either case, you should disclose the conflicl:
PRIOR TO THE VOTE BEING TAKEN by publicly stating 10 the assembly lhe nature of your interesl in the measure on
which you are abslaining from voting; and
WITHIN 15 DAYS AFTER THE VOTE OCCURS ~y compleling and filing this form with the person responsible for recording
lhe minules of lhe meeting, who should incorporate the form in lhe minutes.
APPOINTED OFFICERS:
A person holding appoimive counlY, municipal, or olher local public office MUST ABSTAIN from voting on a measure which
inures to his special privale gain. Each local officer also is prohibiled from knowingly voring on a measure which inures to lhe
special gain of a principal (other lhan a governmenl agency) by whom he is retained.
A person holding an appoimive local office otherwise may participate in a matter in which he has a connicr of interesl, but must
. disclose the nature of the conflict before making any attempl to inriuence lhe decision by oral or wrillen communication, whether
made by the officer or al 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 lhis form (before making any all~mpt to inriuence the decision) Wilh~he on responsible for
recording the minutes of the meeting, who will incorporate the form in the minules.
. A copy or lhe form should be provided immediately to the Olher members of lhe agency. '2--l.{
. The form should be read publicly al lhe meeting prior to consideration of lhe malter in which you have a connicl of inlerest.
FORM ltB. 1..91
PAGE'
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose oral/y the nature or your conflict in the meaSure berore participating.
. You should complete the rorm and file it within 15 days arter the vole occurs with the person responsible ror recording the minutes
or the meeting. who should incorporate the rorm in the minutes.
DISCLOSURE OF LOCAL OFFICER'S INTEREST
'--..I inured to lhe special gain or
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, hereby disclose that on
(a) A measure came or will come berore my agency which (check one)
_ inured 10 my special private gain; or
, by whom I am retained.
(b) The measure berore my agency and the nature or my interest in the measure is as rol/ows:
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"OTICE: UNDER PROVISIONS OF FLORIDA STATUTES ~1J2.317 (1985), A FAILURE TO MAKE ANY REQUIRED
)ISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING:
MPEACHMENT, REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT. DEMOTION, REDUCTION IN
;ALARY. REPRIMAND, OR A CIVIL PENALTY NOT TO EXCEED S5,OOO.
ORM VB. 1-91
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