2008-196A - Laserfiche WebLink

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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 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 DISCLOSURE OF LOCAL OFFICER ' S INTEREST Wesley S . Davis June 17 , 2008 I , hereby disclose that on (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, brother , Brian Davis X- , by inured to the special gain or loss of whom I am retained; or , which _ inured to the special gain or loss of 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 : Relative , Brian Davis , brother , owns a sand mine and may or may not benefit from the decision . 6 / 17 / 08 es EIVIS Sign Date Filed NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES § 112.317, EACHMENTI A FAILURE TO MAKE ANY REQUIRED DISCLOSURE F THE FOLLOWING : IMP CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONEOR MORE OTION REDOCTION N SALARY, EPRIMAND , OR A REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEM CIVIL PENALTY NOT TO EXCEED $ 10 ,000 . PAGE 2 CE FORM 813 - EFF. 1 /2000