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10.03 HRA Appointment
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07-06-2017 City Council Meeting
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10.03 HRA Appointment
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• <br /> Comments: <br /> Conflict of Interest is defined 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 /> If yes,provide details on a separate piece of paper. <br /> t'1 s: s l OCE <br /> Applicant Signature Date <br /> Questions may be directed to the City Clerk's office at 218-568-5222. <br /> Return Completed Application to: City of Pequot Lakes <br /> City Administrator/Clerk <br /> 4638 County Road 11 <br /> Pequot Lakes,MN 56472 <br /> E-mail: nmalecha@pequotlakes-mn.gov <br /> Website: www.pequotlakes-mn.gov <br /> Tins application will be Inept 00 file fon one rear, a/ier that line a neu application mut be filer/ <br /> OFFICE USE ONLY <br /> The Applicant is: New Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to: <br /> Date Appointed: <br /> Term Expires: <br /> Notes: <br /> S:\Administration\City Clerk\Boards and Commissions\Application Process and Forms\Forms\Application Form for Boards and Comnnssions.doc <br /> Page 3 <br />
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