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t SP1CIAL MAGISTRATE APPLICATION <br />v INDIAN 'RIVER COUNTY VALUE. ADJUSTMENT BOARD <br />(APPIJCAN`t:S. MUST MEET QUALIFICATIONS OUTLINED 1N FLA. ti PA.I . S 194,05) <br />Have .you ever been disbarred, suspended or received any other disciplinary action front any organized <br />association, or from the•State of Florida? El No D 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 oftlie circuit court, oftice.of the county attorney orthe value adjustment <br />board of any of the counties to which you are applying: <br />.NONE <br />5. List any clubs, organizations, associations, or other entities.to' which you belong or participate in and in which a <br />possible conflict of:interest could occur or the appearance oi'a' conflict of interest might arise that would prevent <br />you from fait'ly conducting the hearing between the,propert'y.appraiser'and the.property owner andtaxpayer. <br />NONE <br />iti(fl!+t .c <br />f?ursuant to Via. Stat..§ I94.035, a person ,cannot serve as a.speciitl magistrate if he/she is an elected or appointed. <br />official of tr. county, a. taxing,$urisdtction, or the state; is.ari employee,ofa. county, a'taxing jurisdiction.;'or the state; <br />or in the same tax year• that"fie/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 au elected or appointed official or employee of a county.•.a taxing jurisdiction. or the state? 0 Yes No <br />I f yes. .please provid e.detai is <br />The undersigned certifies. under penalty of disquaffcatian. from consideration, that each hem contained in this <br />application, .or any other dacxunent f tritishe(i by Or an behalf oldie applicant is true. and complete as of the date it <br />undemigned authorizes the 'Value Adjustment Hoard to'oluain h f0/•/nation from other sources to vetff' <br />ined•her•ein. The. un dersigns'd,apknineledgesdhcu. ifselectedhelslte'a'I// fnllint all requirements and <br />fn;f:dfilling the duties ofspeciti/ rnagisli'ate. <br />ileus con <br />dates of len+ <br />Pr <br />licitttt' <br />YNES.DAVIS, ESQUIRE <br />e:of App!UCant <br />Date: 4/16/2019 <br />Page. 3 <br />v0:1113/2015 <br />- 28 - <br />