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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 intere�stJ'�any business which could be construed as a conflict of <br /> interest? Yes 1/ No <br /> If yes,provide details on a separate piece of paper. <br /> . <br /> ��� . ' 9' -� � a.� 18 <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 Main Street <br /> Pequot Lakes,MN 56472 <br /> E-mail:nmalecha�a pequotlakes-mn.gov <br /> Website:www.pequoflakes-mn.gov <br /> OF'FICE USE OIYLY <br /> The Applicant is: New Appticant Applytng for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to: <br /> Date Appointed: <br /> Term E=pirts: <br /> Notes: <br /> S:WdminisdatioalCiry Clerk\Baarde and Commiasions�Appliwtion Pracs�end Forms�FormslAppiication Form fm Boards and Commis�ione.doc <br /> Page 3 <br />