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Comments: <br /> Conflld of Interest is defineti as the participation in any activity,recommended action, <br /> or decision from which the individual has or cauld 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 eqiiitable int . in any business which could be const�ued as a conflict of <br /> interest? Yes ��No <br /> If yes,pmvide details on a separate piece of paper. <br /> !f Z <br /> Applicuit Sigiatu�e Date <br /> Questions may be directed to the City Administration�ce at 218-568-5222. <br /> Return Complete�Application to: City of Pequot Lakes <br /> City Administrator <br /> 4638 Main Str�t <br /> Pequot Lakes,MN 56472 <br /> E-mail:�anal�c�a�.�.ucrtl�ak�s-mn�:� <br /> Website:www.peguotlalces-mn.gav , <br /> OFFICE USE ONLY <br /> The AppHcant is: New Applicant Applytng for Reappointment <br /> Counc�l Acflon: Not Appointe�i <br /> Appointed to: '� <br /> Date Appointed• <br /> Term Ezpires: � , <br /> S:Vldminithation�City Clerk�rdc�nd CommissiomWppficallon Pmewa a�FormdFomalApplic�tion Fmm for Bards��I Commiutons.doc <br /> Page 3 <br />