Planning and Zoning Board

FORM 88 MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS MY POSITION IS: D ELECTIVE APPOINTIVE 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 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 voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before completing and filing the form. INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which ould inure to his or her special private gain or loss. Each elected or appointed local officer also MUST ABSTAIN from knowingly voting on easure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained Including the parent, subsidiary, or sibling organization of a principal by which he or she is retained); to the special private gain or loss of a relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies (CRAs) under Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one-acre, one-vote basis are not prohibited from voting in that capacity. For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister, father-in-law, mother-in-law, son-in-law, and daughter-in-law. A "business associate" means any person or entity engaged in or carrying on a business enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange). * * * * * * * ELECTED OFFICERS: In addition to abstaining from voting in the situations described above, you must 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 by 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: Although you must abstain from voting in the situations described above, you are not prohibited by Section 112.3143 from otherwise participating in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision, whether orally or in writing and whether made by you or at your direction. IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN: You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the minutes of the meeting, who will incorporate the form in the minutes. (Continued on page 2) CE FORM 88- EFF. 1112013 PAGE 1 Adopted by reference in Rule 34-7.010(1)(f), F.A.C.  APPOINTED OFFICERS (continued) " ' A copy of the form must be provided immediately to the other members of the agency. ~~~~~ The form must be read publicly at the next meeting ~fter the form is filed. IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING: • You must disclose orally the nature of your conflict in the measure before participating. • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the agency, and the form must be read publicly at the next meeting after the form is filed. DISCLOSURE OF LOCAL OFFICER'S INTEREST I, ~]1 AD ,)..\:etc.{ ,hereby disclose that on Sv. V\ 1!. (\ ~ .2ol.i: (a) A measure came or will come before my agency which (check one or more) inured to my special private gain or loss; inured to the special gain or loss of my business associate, - - - - - - - - - - - - - - - - - - - - - - inured to the special gain or loss of my relative, _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ inured to the special gain or loss o f - - - - - - - - - - - - - - - - - - - - - - - - - - - - - · by whom I am retained; or inured to the special gain or loss o f - - - - - - - - - - - - - - - - - - - - - - - - - - - - , which is the parent subsidiary, or sibling organization or subsidiary of a principal which has retained me. (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: ~ lt> A 1?ML lA r ile se "..\-\ "'11 G\ s· ;-\t f \A"':' 0: 'fV\ e 0> Me;, +\,-R (4 l €~A'RJ), A_V\ \ ~ 6A~e_~{ ,J-)~\-\~ v<J (A~ --\--\) r\. Q.(J.,.,.DfV.J-..} vJ~\\ lo-t sh.ovJ'v-..'1 A.rd· 1"1?' ~~.<_ CA-\ \.}\ r 0J...N.. ft' y ' r t ~ U -i?Al'\ O"-g 4~ett-'-f'v If disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer, who is also an attorney, may comply with the disclosure requirements of this section by disclosing the nature of the interest in such a way as to provide the public with notice of the conflict. Date Filed r I s'9nature ~ NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT, ~~MOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A ~w_!VIL PENALTY NOT TO EXCEED $10,000. CE FORM 88- EFF. 11/2013 PAGE 2 Adopted by reference in Rule 34-7.010(1}(f), F.A.C.