26 Neisen Kasdin 10/2/98 R5A
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FORM 88 MEMORANDUM OF VOTING CON LlCT FOR
COUNTY, MUNICIPAL, AND OTHER lOCAL PUBLIC OFFICERS
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NA2 ~ ""ARO, CO(!(j mm; ^J'Jld/(/OMMllTEE
I HE HOARD. COUNCil,. COMMISSION. AUTHORITY OR COMMITTEE ON
WHICH I SERVE IS A UNIT Or:
~-y a COUNTY a OlHER lOCAl. AGENCY
C1ry
M V POSITION IS;
NAME Of' POl.ITICAL SUBDI....rSION:
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ELECTIVE '0 "'ppm~II."E~ ....
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WHO MUST FILE FORM 8B.,
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 conflict of interest under Section 112.3143. Florida Statutes.
Your responsibilities under the law when faced with a measure in whicb you hilve'a conflict of interest will vary greatly depending
on whether you hold an elective or ,appointive positIon. For this reason, please pay'c1ose attention tothc.mstt.llClionson tllis form
before completing the reverse s[de and .fiHng the forin: . .. . . . .. " " " ~',
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INSTRUCTIONS FOR COMPLIANCE WITH SECTION"l1~.314a,fJ.ORIDA STATUTES'
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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,ain 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 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 conflict of interest. but must
disclose the nature of the conflict before making any attempt to influence the decision by oral or wrillen 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 influence the decision) with the perS0T)n res . Ie 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. ~
. The form should be read publicly at the meeting prior to consideration of the matter in which you have a conflict of interest.
'E FORM~8. 1--91
PAGE I
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IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
. 'You should disclose orally lhe nalure..of you: confli~t in lhe measure before participating. .
. You should ,-amplere rhe forrri' and file it within 15 days arler lhe vole occurs with lhe person responsible for (.cording lhe minutes'
of the meeting, who should incorporate the form in the minutes: , '
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, . ... , "DISCLOSURE OF lOCAL OFFICER'S' INTEREST
IV ~ Is.eAI kA-f'lJ / N' . hereby disclose thar on ()e TIJ4!L ~
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(a) A measure ~ame or will come before my agency which (check one)
_ inured to my special private gain; or
~ inured to the special gain of fI/XI1~ ~. , by whom I am retained.
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Date Filed
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Signature
NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES ~1I2.317 (1985), A FAILURE TO MAKE ANY REQUIRED
DISCLOSURE CONSTITUTES GROUNDS FOR AND MA Y BE 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 S5,OOO.
fORM ij8 ~ 1-91
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