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APPOINTED OFFICERS ( continued ) • immediately to the other members of the agency . A copy of the form must be provided • 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 11 HIM DISCLOSURE OF LOCAL OFFICER ' S INTEREST Bob Solari May 15 20 2 li hereby disclose that on (a) A measure came or will come before my agency which (check one) XX 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 , 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 : I am a Commercial property , owner adjacent to the proposed Land Development Regulation change . I May 15 , 2012 11111 11 1 11 1 Signature Date Filed Will NINE NINE I HIM III III I WE NINE r TIC11 E:iiiiii UIII ND11 ER IIII PIII R 11 O 11 V 11 I 111 S 11 I 11 O 111 NS 11111 O 11 F IIII F 11 LORIDA STATUTES § 112 . 317 , A FAILURE TO MAKE ANY REQUIRED DISCLOSURE NSTITUTES GROUNDS FOR ANDMAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING :FFICE OR EMPOYMENT , DEMOTIONREDUCTION IN SALARY , REPRIMANDMOR A MOVAL OR SUSPENSION FROM OIL PENALTY NOT TO EXCEED $ 10 ,000 . PAGE 2 CE FORM 813 - EFF. 1 /2000