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LAST NAME —FIRST NAME — MIDDLE NAME NAME OF BOARD, COUNCIL COMMISSION, AUTHORITY, OR COMMITTEE
<br />Hale, Daniel A. Planning and Zoning Commission
<br />MAILING ADDRESS THE BOARD, COUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON
<br />325 Southcot Dr WHICH I SERVE ISAUNITDF:
<br />cmr t, COUNTY IYCITY n COUNTY a OTHER LOCALAGeNCY
<br />Casselberry Seminole NAME OF POLITICAL SUBDIVISION:
<br />N/A
<br />DATE ON WHICH VOTE OCCURRED MY POSPTION is:
<br />14 August 2013 ❑ ELECTIVE APPOINTIVE
<br />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,
<br />commission, authority, or committee. It applies to members of advisory and non - advisory bodies who are presented with a voting conflict of
<br />interest under Section 112.3143, Florida Statutes.
<br />Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending
<br />on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before
<br />completing and filing the form.
<br />A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which
<br />would inure to his or her special private gain or loss. Each elected or appointed local officer also MUSTABSTAIN from knowingly voting on
<br />a measure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained
<br />(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
<br />relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies (CRAB) under
<br />Sec, 163,356 or 163.357, 1=,S., and officers of independent special tax districts elected on a one -acre, one -vote basis are not prohibited
<br />from voting in that capacity.
<br />For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister; father -in -law,
<br />mother -in -law, son-in -law, and daughter4ri -law. A "business associate" means any person or entity engaged in or carrying on a business
<br />enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation
<br />are not listed on any national or regional stock exchange).
<br />ELECTED OFFICERS:
<br />In addition to abstaining from voting in the situations described above, you must disclose the conflict:
<br />PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are
<br />abstaining from voting; and
<br />WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the
<br />minutes of the meeting, who should incorporate the form in the minutes,
<br />'•! • i
<br />Although you must abstain from voting in the situations described above, you are not prohibited by Section 112.3143 from otherwise
<br />participating in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision,
<br />whether orally or in writing and whether made by you or at your direction.
<br />IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION ARIORTO THE MEETINGAT WHICH THE VOTE WILL BE
<br />TAKEN:
<br />• You must complete and file this form (before making any attempt to influence the decision) with the person responsible for recording the
<br />minutes of the meeting, who will incorporate the form in the minutes. (Continued on page 2)
<br />CE FORM 8B - EFF, 1112013 PAGE I
<br />Adopted by reference in Rule 34- 7.010(1)(0, F.A,C.
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