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SPECIAL MAGISTRATE APPLICATION <br />INDIAN RIVER COUNTY VALUE ADJUSTMENT BOARD <br />(APPLICANTS MUST MEL—T QUALIFICA"PIONS OUTLINE D IN FLA. STAT. S 194.035) <br />3. Have you ever been disbarred, suspended or received any other disciplinary action from any organized <br />association, or from the State of Florida? E] No ❑ Yes (please explain) <br />4. List any personal or business relationship you have ever had with any officer or employee of the office of the <br />property appraiser, office of the clerk of the circuit court, office of the county attorney or the value adjustment <br />board of any of the counties to which you are applying: <br />Business relationships through the VAB process. <br />5. List any clubs, organizations, associations, or other entities to which you. belong or: participate 7in and in which a <br />possible conflict of interest could occur or the appearance of a conflict of interest might arise that would prevent <br />you from fairly conducting the hearing between the property appraiser and the property owner and taxpayer. <br />N/A <br />Pursuant to Fla. Stat. § 194.035, a person cannot serve as a special magistrate if he/she is an elected or appointed <br />official of a county, a taxing jurisdiction, or the state; is an employee of a county, a taxing jurisdiction, or the state; <br />or in the same tax year that lie/she services the Board as a special magistrate, represents a party before the Board in <br />any administrative review of property taxes. <br />Are you an elected or appointed official or employee of a county, a taxing jurisdiction, or the state? El Yes 91 No <br />If yes, please provide details: <br />The undersigned certifies, under penalty of disqualification f•onr consideration, that each item contained in this <br />ap/?lication, or any or document fitr•r�ished by or on behalf of the applicant is true and complete as of the date it <br />becns The..undersy,171,111 authorizes the ►slue Adjustment Board to obtain h?formation r6nr other sources to verifyrr. The undersigned acknowledges that, ifselected, he/she will follow all i equit eirterits at�d <br />�randates of late nfilling the duties of sl.7ecial magistrate. <br />Date: 6/6117 <br />Signature of Al' plicant <br />Stephen G' Neill <br />Printed Nam 'of Applicant <br />Page 3 <br />vO l/13/2015 <br />-25- <br />