20 Neisen Kasdin 4/1/98 R5A
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FORM 88 MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
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'""'--',\OlE Ot- HOARO. C:OU~C]I. c.'O....I,'oiIS,...l(),... "1;1 HOKl1'y. OR (,'OM.'.illT/ZE
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I HE HlMRL>. COU,~CII.. CO.\l.\I/SSI0N. ....UrHORlrY OR CO,\-..\.1ITTEE ON
""HICH I SERVe IS..\ UNITal"-
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~ ('IlY C COU:'liTY 0 OlHER ,-OCotol. "{;E~CY
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MY PO~ITION 15:
I; El..:I.""7'I....e C ..VrQL..Tl\"e
WHO MUST FlU FORM 88
This form is for use by any person serving at the COUnty. ciey, or other local level of government on an appointod or elected board.
'ouncil. commission. authority. or committee. It applies equally to members of advisory and non.advisory bodies who are presented
.'irh a vocing cont1kt of ineerese under Section 112.3143, Florida Statutes.
(our ,~sponsibilities under the law when faced wieh a measure in which you have a contlict of interest will vary greatly depending
'n whether you hold an elective or appointive position. For this reason, please pay close attemion to the instructions tln this form
efore completing the rev'erse side and filing the form.
INSTIlUCTIONS FOil COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
LECTED OffICERS:
person holding elective COUnty. municipal, or other local public office MUST ABSTAIN from voting on a measure which inures
his special private gain. Each local officer also is prohibited from knowingly voting on a measure which inures to the special
in of a principal (other than a government agency) by whom he is retained.
either case, you should disclose the contlict:
PRIOR TO THE VOTE BEING TAKEN by publicly stating to Ihe assembly the nature of your interest in the measure on
which you are abstaining from voting; and
WITHIN 15 DAYS AfTER THE VOTE OCCURS "y completing and filing this form wirh the person responsible for recording
the minures of the meering, who should incorporate the form in the minules.
POINTED OFfICERS:
~rson holding appointive county. municipal. or olher local public office MUST ABST....IN from voting on a measure which
.~s [0 his special privat.: !o.in. Each local officer also is prohibited from knowingly voting on a m~:lsure which inures to the
ial gain of a principal (othe, than a government agency) by whom he is retained_
~rson holding an appointive local office otherwise may participate in a matter in which he: has a canilier of interest. but mu~'(
us.e' the nature of the contlict before making any a([c:mpt co inrluence ehe decision by oral or written communication, whether
~ by the offic" or at his direcrion.
JU INTEND TO ."'fAKE ANY ATTE."'fPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH
VOTE WILL BE TAKEN:
; should complete and file this form (before making any attempt 10 int1uence the decision) with the person re
ording the minutes of the meering, who will incorporate the form in the minutes.
opy of the form should be provided immediately to the other members of [he agency.
form should be read publicly at the meering prior 10 consideration of the matter in which you have a con
, te for
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p..to.CE 1
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IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You should disclose orally the nacure of your conflicl in the measure before participating.
. You should complete the form and file it within 15 days afcer the voCe occurs with che person responsible for recording the minutes
of the meecing. who should incorporate the form in che minutes.
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DISCLOSURE OF LOCAL OFFICER'S INTEREST
. ,8PR-I1-
. hereby disclose that on
/
.1918-:
(a) A measure came or will come before my agency which (check one)
_ inured to my SPCCi31 privilte gain; or
./ inured to the special gain of -0 f 1-~1M ~~ );. rw...; \I"e\~
(b) The measure before my agency and che nature of my interest in che meaSure is as follows:
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. by whom I am retained.
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Filed
Signature
CE: UNDER PROVISIONS OF FLORIOA STATUTES ~1l2.317 (1985). A FAILURE TO MAKE ANY REQUIRED
:"OSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING:
ACH.\IENT. RE.\tOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DE.\IOTION. REDUCTION IN
RY, REPRIMAND. OR A CIVIL PENALTY NOT TO EXCEED S5.000.
P.."OE!
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