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F <br /> POINTED OFFICERS (continued ) <br /> copy of the form must be provided immediately to the other members of the agency . <br /> he form must be read publicly at the next meeting after the form is filed . <br /> IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING : <br /> • You must disclose orally the nature of your conflict in the measure before participating . <br /> • You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes <br /> of the <br /> meeting , who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the <br /> agency, and the form must be read publicly at the next meeting after the form is filed . <br /> DISCLOSURE OF LOCAL OFFICER'S INTEREST <br /> FWesleS . Davis hereby disclose that on December $ <br /> 20 OS <br /> (a ) A measure came or will come before my agency which (check one) <br /> inured to my special private gain or loss , <br /> inured to the special gain or loss of my business associate, <br /> .X. inured to the special gain or loss of my relative, brother . Bri an Da Vi c <br /> _ inured to the special gain or loss of <br /> whom I am retained ; or by <br /> _ inured to the special gain or foss of <br /> , which <br /> is the parent organization or subsidiary of a principal which has retained me . <br /> (b) The measure before my agency and the nature of my conflicting interest in the measure is as follows: <br /> Relative , Brian Davis , brother , owns a sand mine and may or may not benefit from the decision . <br /> December 8 2008 <br /> Date Filed <br /> Signature ey <br /> =REMOVALOR <br /> OVISIONS OF FLORIDA STATUTES § 112 . 317 , A FAILURE TO MAKE ANY REQUIRED DISCLOSURE <br /> UNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING : IMPEACHMENT , <br /> ENSION FROM OFFICE OR EMPLOYMENT, DEMOTION , REDUCTION IN SALARY, REPRIMAND , OR A <br /> TO EXCEED $ 10 , 000 . <br /> CE FORM 86 - EFF. 1 /2000 <br /> PAGE 2 <br />