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Comments: �a,�c vou -�o✓ ��ou r Cohs lA�rfa�o„ <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 construed as a conflict of <br /> interest? Yes �No <br /> If yes,provide details on a separate piece of paper. <br /> Cr��� � N o� 7 �0/S <br /> �' <br /> Applicant Signature D� <br /> Quesrions 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 <br /> 4638 Main Street <br /> Pequot Lakes,MN 56472 <br /> E-mail:nmalechann,�uotlakes-mn.gov <br /> Website:www.pequotlakes-mn.gov <br /> OFFICE USE ONLY <br /> The Applicant is: l�Tew Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to: <br /> Date Appomted: <br /> Term Ezpires• <br /> Notes: <br /> C:\Use�ss�cityhall�AppDatnU.apflMicroso8lWmdows�INetCncLe\CoMenkOirtlook�CPZCH3R]�Appliaitian Form for Boards and Commissions.doc <br /> Page 3 <br />