Laserfiche WebLink
� Conflict of Interest is deiined as the participation in any activity, recommended action, <br />or decision from which the individual has or could have the potential to receive personal <br />gain, whether it is direct or indirect. In accordance with this definition, do you have any <br />legal or equitable interest in any business which could be construed as a conflict of <br />interest? Yes �No <br />� <br />If yes, provide details on a separate piece of paper. <br />� ���� l— � l� �za /`� <br />licant Signature Date <br />Questions may be directed to the City Clerk's office at 218-568-5222. <br />Return Completed Application to: <br />City of Pequot Lakes <br />City Clerk <br />4638 County Road 11 <br />Pequot Lakes, MN 56472 <br />E:mail: speine@�quotlakes-mn.gov <br />Website: �vww.�epuotlakes-mn.Qov <br />Tlris uppliruriun tirill b� kc�pr un.tilr'.fiu� une• ��r���r: ajr��r �h�it nm� u neir uPplicariur� nn�.st hr t�ir�cl. <br />OFFICE USE ONLY <br />The Applicant is: <br />Council Action: <br />Notes: <br />, �; , . <br />New Applicant <br />Not Appointed <br />Appointed to: _ <br />Date Appointed: <br />Term Expires: _ <br />Applying for Reappointment <br />. . , . . .. r,. � <br />`� - C:\Documen[s and Settings\nmalecha\Local Settings\Temporary Intemet Files\OLK4\Application Form for Boazds and Commissions.doc <br />Page 3 <br />