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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 construerl as a conflict of <br /> interest? Yes No <br /> If yes,provide details on a sepazate piece of paper. <br /> G��.e��—�/ � ( — ��o s �`� <br /> Applicant Signature Date <br /> Questions may be directed to the City Administration 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: nmalechana,nequotlakes-mn.gov <br /> Website: www.pequotlakes-mn.gov <br /> . . . . . <br /> OFFICE USE ONLY <br /> The Applicant is: New Applicant Applying for Reappointrnent <br /> Council Action: Not Appointed <br /> Appointed to• <br /> Date Appointed• <br /> Term Ezpires• . <br /> S:Wdministration\City C1erk�Boarda ond Commissions�Application Process end Forma�Forms�Application Form for Boards and Commissions,doc <br /> Page 3 <br />