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SPECIAL MAGISTRATE APPLICATION <br />INDIAN RIVER COUNTY VALUE ADJUSTMENT BOARD <br />(APPLICANTS MUST MEET QUALIFICATIONS OUTLINED IN FLA. -15-1-A.1-194.035)` <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? ® 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 />ONE <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 />wail VA[1gy,. however, it would not create.a conflict. If I personpl!1know the petitioner I would withdraw <br />CERTIFICATIOti <br />Pursuant to Fla. Stat. § 194.035, a person cannot serve as a special magistrate if hetshe 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 he/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? ❑ Yes ® No <br />If yes, please provide details: <br />The undersigned certifies, tinder penalty of disqualification from consideration, that each item contained in this <br />application, or an}- other doctmtent fttrnished by or on behalf of the applicant is trite and complete as of the date it <br />hears. The undersigned authorizes the I'ahie Adjustment Board to obtain information from other sources to verb <br />each item contained herein. The undersigned acknowledges that, ifselected, he/she will follow all requirements and <br />mandates of law in f tlftlling the duties of special magistrate. <br />-9 (11. 091, <br />Date: za CP <br />Signature 6PAppliaW <br />Ste_illen,J Boyle _ <br />Printed Name of Applicant <br />Page 3 <br />v01113t2015 <br />-33- <br />