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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 equitable interest in any business which could be construed as a conflict of <br /> interest? Yes �No <br /> If yes,provide details on a sepazate piece of paper. <br /> 7 IZ3 I� S� <br /> Applicant Sigaature Dat <br /> Questions may be directed to the City Clerk's office at 218-568-522�. <br /> Return Completed Application to: City of Pequot Lakes <br /> City Administtator <br /> 4638 Main Street <br /> Pequot Lakes, MN 56472 <br /> E-mail: nmalecha(c�.peauotlakes-mn. o�v <br /> Website: www.pequotlakes-mn.gov <br /> . . . <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 Ezpires• <br /> Notes: <br /> C:\Usccs�cityhalMppData�I.ocaNNicrosoft\Wi�owsVNctCache\Conto�.0utlook\CPZCH3RMpplication Fotm for Boa�ds and Commissions.doc <br /> Page 3 <br />