FORM
<br />8B MEMORANDUM OF VOTING CONFLICT FOR
<br />COUNTY,
<br />MUNICIPAL, AND
<br />OTHER LOCAL PUBLIC OFFICERS
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<br />ME—FIRST NAME—MIDDLE NAM�EI_
<br />NAME OnF BOARD, COUNCIL, COMMISSION, AUTHORITY, OR COMMITTEE
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<br />MAILING ADDRESS
<br />THE BOARD, tOUNCIL, COMMISSION, AUTHORITY OR COMMITTEE ON
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<br />WHICH I SERVE IS A UNIT OF:
<br />�'III 6'TY ❑ COUNTY ❑ OTHER LOCAL AGENCY
<br />CITY
<br />COUNTY
<br />NAME OF POLITICAL SUBDIVISION: „
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<br />DATE ON WHICH VOTE OCCURRED
<br />MY P ITI N IS: /
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<br />W ELECTIVE ❑ APPOINTIVE
<br />WHO MUST FILE FORM 813
<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 />INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
<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 MUST ABSTAIN 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 (CRAs) under
<br />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
<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 daughter-in-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 />APPOINTED OFFICERS:
<br />Although you must abstain from voting in the situations described above, you are not prohibited by Section 1.12.3143.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 ANYATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT 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 SB - EFF. 11/2013 HAUt l
<br />Adopted by reference in Rule 34-7.010(1)(f), F.A.C.
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