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r ' SPECIAL MAGISTRATE APPLICATION <br />INDIAN RIVER COUNTY VALUE ADJUSTMENT BOARD <br />(APPLICANTS MIMI- MI?61'QI.IAi IFICATIONS OUTLiNF.1) IN FLA. STATJ 194.035) <br />2. Of those organizations describe any possible conflict of interest that could occur or the appearance of a conflict <br />of interest that may prevent you from fairly conducting a hearing: <br />3. Have you ever been disbarred, suspended or received any other disciplinary . action from any orgamzea <br />association, or from the State of Florida? ®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 in 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 />None <br />CERTIFICATION <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; or <br />in the same tax year that he/she services the Board as a special magistrate, represents a party before the Board in any <br />administrative review of property taxes. <br />Are you an elected or appointed official or employee of a county, a taxing jurisdiction, or the state? ❑ Yes ® No <br />If yes, please provide details: <br />The undersigned certifies•, to cler penal), of disqualification fi•onc consideration, that each item contained in this <br />application, or ai7y other document ficrnishecl by or on behalf of the applicant is true and complele as of the dale it <br />bears. The undersignednlhorizes the Value Adjustment Board to obtain information from other sources to verify <br />each item containecl��lddt �. The undersigned acknowledges that, ifseleclecl, he/she will follow all requirements and <br />mandates o h" r Pyu[itiling the duties of s?mcial magistrate. <br />Date: 4/20/20 <br />Sienatum(of <br />Stephen G. Neill <br />Printed Name of Applicant <br />Page 3 <br />v01/ 13/2015 <br />-16- <br />