HomeMy WebLinkAboutMemorandum 06-24-2002FORM 813 MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
LAST NAME - -FIRST NAME --- MIDDLE NAME
NA E OF BOARD COUNCIL CO M AUTHORITY OR COMMITTEE
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THE BOARD COUNCIL COMMISS100
AUTHORITY OR COMMITTEE ON
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ITY ❑ COUNTY
❑ OTHER LOCAL AGENCY
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NAME OF POLITICAL SUBDIVISION
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DATE ON WHICH VOTE OCCURRED
MY POSITIA IS
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❑ ELECTIVE
45�- APPOINTIVE
WHO MUST FILE FORM 813
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 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 the reverse side and filing the form
INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112 3143 FLORIDA STATUTES
A person holding elective or appointive county municipal or other focal public office MUST ABSTAIN from voting on a measure which
inures to his or her special private gain or loss Each elected or appointed local officer also is prohibited from knowingly voting on a mea
sure which inures to the special gain or loss of a principal (other than a government agency) by whom he or she is retained (including the
parent organization or subsidiary of a corporate 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 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 officers 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 min
utes 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 otherwise may participate 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 other side)
CE FORM 8B EFF 112000 PAGE 1
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 after the form is fled
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 OFFICERS INTEREST
r _ A -- C2 - 1 e-r vv"" hereby disclose that on Fq e__, 0 20 0 -�-
(a) A measure came or will come before my agency which (check one)
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 ----------- - ____________ W ____ ------------------------------ _ --
inured to the special gain or loss of ----------------- -w __ -------- ___ by
whom I am retained or
inured to the special gain or loss of - - -____ which
is the parent 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
________________
__ _ ___________ ____________
Date Filed Signature
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
REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT DEMOTION REDUCTION IN SALARY REPRIMAND OR A
CIVIL PENALTY NOT TO EXCEED $10 000
CE FORM 8B EFF 112000 PAGE 2