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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 equita.ble interest in any business which could be conshued as a conflict of <br /> interest? Yes � No <br /> If yes,provide details on a separate piece of paper. <br /> � <br /> l � . <br /> A plican.t 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 Main Street <br /> Pequot Lakes, MN 56472 <br /> E-mail: nmalecha.(�a,pequotlakes-mn..gov <br /> Website:Evww.pec�uotlakes-mn.gov <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:WdministrarionlCity Clerk\Boards and Commissions�Application Process and Forms�Fortns�Application Form for Boazds and Commissions.doc i <br /> Page 3 � <br />