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s I ■ p I I FORM 8B MEMORANDUM OF VOTING CONFLICT FOR COUNTY, MUNICIPAL , AND OTHER LOCAL PUBLIC OFFICERS AST NAME- FIRST NAME- MIDDLE NAME NAME OF BOARD, COUNCIL. COMMISSION , AUTHORITY, OR COMMITTEE Davis Wesley �Q �� • 4AILING ADDRESS THE BOARD , COUNCIL, C MMISSION, AUTHORITY OR COMMITTEE ON 1801 27th Street , WHICH I SERVE IS A UNIT OF: ; ITYCOUNTY ❑ CITY RCOUNTY O OTHER LOCAL AGENCY Vero Beach Indian River NAME OF POLITICAL SUBDIVISION: )ATE ON WHICH VOTE OCCURRED MY POSITION IS : May 17 -, 201 .1 ELECTIVE ❑ APPOINTIVE WHO MUST FILE FORM 813 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 , commission , authority , or committee . It applies equally to members of advisory and non -advisory bodies who are Presented with a voting conflict of interest under Section 112 . 3143 , Florida Statutes . Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending on whether you hold an elective or appointive position. For this reason , please pay close attention to the instructions on this form before completing the reverse side and filing the form . INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112 . 3143 , FLORIDA STATUTES A person holding elective or appointive county , municipal , or other local public office MUST ABSTAIN from voting on a measure which inures to his or her special private gain or loss . Each elected or appointed local officer also is prohibited from knowingly voting on a mea- sure which inures to the special gain or loss of a principal ( other than a government agency) by whom he or she is retained ( including the parent organization or subsidiary of a corporate principal by which he or she is retained ) ; to the special private gain or loss of a relative ; or to the special private gain or loss of a business associate . Commissioners of community redevelopment agencies under 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 from voting in that capacity . For purposes of this law , a "relative" includes only the officer' s father, mother, son , daughter , husband , wife , brother, sister, father- in - law, 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 enterprise with the officer as a partner, joint venturer , coowner of property , or corporate shareholder (where the shares of the corporation are not listed on any national or regional stock exchange ) . ELECTED OFFICERS : In addition to abstaining from voting in the situations described above , you must disclose the conflict : PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are abstaining from voting ; and WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the min - utes of the meeting , who should incorporate the form , in the minutes . APPOINTED OFFICERS : Although you must abstain from voting in the situations described above , you otherwise may participate in these matters . However, you must disclose the nature of the conflict before making any attempt to influence the decision , whether orally or in writing and whether made by you or at your direction . IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE TAKEN : You must complete and file this form (before making any attempt to influence the decision ) with the person responsible for recording the minutes of the meeting , who will incorporate the form in the minutes. ( Continued on other side) CE FORM 813 - EFF . 1 /2000 PAGE 1