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Comrnents: <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 t}us definition,do you have any <br /> legal or equitable interest in any business wluch could be construed as a conflict of <br /> interest? Yes �_No <br /> If yes,provide details on a separate piece of paper. <br /> � a � <br /> � � ���' , <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 I.akes,MN 56472 <br /> E-mail: nmalechana,neauotlakes-mn.�ov, <br /> � Website:www.pequotlakes-mn.gov <br /> I <br /> ' i <br /> � <br /> OFFICE USE ONLY <br /> • The Applicant is: New Applicant Applying for ReAppoiatment �, <br /> Council Actioa: Not Appointed � <br /> Appointed to• , <br /> Date Appointed• <br /> Term Ezpirea• � <br /> S:WdminLaratbalCiry Clerk\Boards a�Commissions�Applieetfon Pcxeas aod Forms\Fomn�Appikation Fmm for Boerds ud Commiuiom.doc <br /> Page 3 <br />