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Comments: <br /> Canflict of Interest is defined as the partieipation in any activity,recommended actiot�, <br /> or decision �rom which the individual has or could have the potential to receive personal <br /> gain,whether it is direct or indirect. In accardance with this definitian,do you have any <br /> legal or equita.ble `vnterest in any business which could be construed as a conflict af <br /> interest? Ye$ X Nv <br /> If yes,pravide detaiis on a separa.�e piece of paper. <br /> . lZ� 12� �7 <br /> A licant Signat�re Date <br /> Questions may be directed to the City Clerk's office at 218-568-5222. <br /> Retw�n Completed.Application to: City af Pequot Lakes <br /> Ci�y AdministratcsrJClerk <br /> 4638 Main Street <br /> Pequot Lakes,MN Sb4�2 <br /> E-mail:nmalecha�'a�pequotlakes-mn.�ov <br /> Website:www.pequatlakes-mn,�ov <br /> OFFICE USE ONLY <br /> The Appliceat is: l�ew Appiirant Applying tor Reappaintment <br /> Coancil Action: Not Appoint�d <br /> Appolnted to• <br /> Date Appointed• <br /> Term Expires• . <br /> Notes: <br /> S:1AdminisirationlCiry Clerk\Bnards cnd Commissio�lAgplicatinn P�acees and FormstFormslApplicat�on Fam for Bouds and Commissians.dnc <br /> Page 3 <br />