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. � <br /> I <br /> Comments• <br /> Contlict of Interest is defined as the participation in any activity,recommended action, <br /> or decision from which the individuai has or could have the potential to receive personal <br /> gain,whether it is direct or indir�ct In accordance with this definition,do you have any <br /> legal ar equitable iaterest in any business which could be construed as a conflict of <br /> int�rest? Yes �No <br /> If yes,provide details on a se c pi�e of paper. <br /> 9 �T,�'' <br /> iJ <br /> Applicant Signabue Date <br /> Questions may be directed to the City Adminisbration 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:nmale�I�a�a)pequdttakes-mn.gdv <br /> Website:www.�ec�uotlakes-mn.gov <br /> OFFICE USE ONLY <br /> T6e Appllcant fs: New AppHcant Applytng for Reappointment <br /> Counci!AcNon: Not Appointed <br /> Appointed to- <br /> Date Appointed: <br /> Term Fapires: <br /> s:u�amt����cny c�e�Bo.�a�.aa co�toa,v�u�r�o�a.�a r�t�mm.�u�on Fmm rm soaa•.oe cmnn�imn.aa <br /> Page 3 <br />