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Background This form is used to report additional compensation that of¿ cials receive when appointing themselves to positions on committees, boards or commissions of a public agency, special district, and joint powers agency or authority. For example, a city councilmember may be appointed to serve as the city’s representative on a joint powers insurance authority or a metropolitan planning organization or mayor. (Regulation 18705.5, amended 03.2012) Each agency must post on its website a single Form 806 which lists all the paid appointed positions. When there is a change in compensation or a new appointment, the Form 806 is updated to reÀ ect the change. The form must be updated as changes occur. Initial Agency Posting As soon as possible, each agency should prepare a Form 806 identifying all of the current paid appointments to other governmental agencies. Thereafter, the form may be amended to include the future appointments. Instructions This form must be posted prior to a vote (or consent item) to appoint a governing board member to a paid position on another agency. Part 1. Agency Identifi cation Identify the agency name and information on who should be contacted for information. Part 2. Appointments Identify the name of the other agency, board or commission. List the name of the of¿ cial, and an alternate, if any. List the appointment date and the length of term the agency of¿ cial will serve. Disclose the stipend provided per meeting and the estimated annual payment. The annual salary is an estimate as it will likely vary depending on the number of meetings. It is not necessary to revise the estimate at the end of the calendar year. Part 3. Verifi cation The agency head or his/her designee must sign the veri¿ cation. Frequently Asked Questions (FAQs) 1. When does an agency need to complete the Form 806? A Form 806 is required when an agency’s board members vote on an appointment for a board member to serve on another governmental agency and pay is provided. 2. The city council votes to serve as the city’s housing authority, a separate entity. Will the Form 806 be required? If the council members receive an additional compensation for serving on the housing authority, the Form 806 is required. If there is no payment, the Form 806 is not required. 3. Are appointments made by a governing board to appoint one of its members to serve as an of¿ cer of that board for additional pay (e.g. mayor) required to be disclosed on Form 806? Yes. Regulation 18705.5 permits voting on your own appointment to position of mayor as well as other boards and commissions so long as proper disclosure on the Form 806 is made. This exception and disclosure apply to agencies with governing boards that are elected or appointed. 4. In determining the salary, must the agency include mileage reimbursements, travel payments, health bene¿ ts, and other compensation? No. The FPPC regulation only requires the reporting of the stipend or salary. 5. Which agency must post the Form 806? The agency that is voting to appoint a public of¿ cial must post the Form 806 on its website. The agency that the of¿ cial will serve as a member is not required to post the Form 806. The form is not sent to the FPPC. 6. When must the Form 806 be amended? The Form 806 should be amended upon any of the following circumstances: the number of scheduled meetings is changed, there is a change in the compensation paid to the members, or there is a change in membership on the board or commission. 7. When a body meets irregularly, how should the annual compensation be estimated? The agency should estimate compensation using the highest number of meetings. 8. In 2013 our agency will have a new appointment to a new agency. How is the Form 806 updated? Before the agency votes on the appointment, the agency should update the Form 806 and identify the other governmental entity’s name. If known, also include other information such as the number of meetings and stipend. As long as that information is posted prior to a vote of the governing board on an appointment, the agency is in compliance with Regulation 18705.5. Following the vote, the agency must update the form to identify the individual that will serve. Privacy Information Notice Information requested by the FPPC is used to administer and enforce the Political Reform Act. Failure to provide information may be a violation subject to penalties. All reports are public records available for inspection and reproduction. Direct questions to FPPC’s General Counsel. Fair Political Practices Commission, 428 J Street, Ste. 620, Sacramento, CA 95814. FPPC Form 806 (5/12) FPPC Toll-Free Helpline: 866/ASK-FPPC (866/275-3772) California Form 806 A Public Document Agency Report of: Public Offi cial Appointments