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APPOINTED OFFICERS (continued)
. A copy of the form must be provided immediately to the other members of the agency.
. The form must be read publicly at the next meeling after the form is filed.
IF YOU MAKE NO ATTEl,llPT TO INFLUENCE THE OECISION EXCEPT BY DISCUSSION AT THE MEETING:
. You must disclose orally the nature of your conflict in the measure before participating.
. You must complete the form and file it within 15 days after the vote ocrurs with the person responsible for recording the minutes of the
meeting, who must incorporate the form in the minutes. A copy of the form must be provided immediately to the other members of the
agency, and the form must be read publicly at the next meeting affer the form is flled.
DISCLOSURE OF LOCAL OFFICER'S INTEREST
l,Archibald Ryan lV , hereby disclose that on al26l 20
(a) A measure came or will come before my agency which (check one or more)
_ inured to my special private gain or loss;
_ inured to the special gain or loss of my business associate,
--J inured to the special gain or loss of my relative Father, Unclet
by
, which
is the parent subsidiary or sibling organization or subsidiary of a principal which has retained me.
(b) The measure before my agenry and the nature of my conflicting interest in the measure is as follows
llem 12.2, on 8./26 agenda, private application of father and Uncle to rezone property to Gateway
Mixed Use ll District for the property located at 700 East Dania Beach Boulevard,
Dania Beach, FL 33004
lf disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer,
who is also an attomey, may crmply with the disclosure requirements of this section by disclosing the nature of the interest in such a way
as to provide the public with notic€ of the conffict
p c /{
Date Filed Signature
NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES 5112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE
CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT,
REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY REPRIMAND, OR A
CIVIL PENALTY NOTTO EXCEED $1O,OOO.
PAGE 2
_ inured to the special gain or loss of
whom I am retained; or
_ inured to the special gain or loss of
CE FORM 8B - EFF. 11/2013
Adopted by reference in Rule 34-7.010(1Xf), F.A.C.