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Comments: � ��- �h��� ! <br /> Conflict of Interest is defined as the participadon 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 construed as a conflict of <br /> interest? Yes � No <br /> If yes,provide details on a separate piece of paper. <br /> �Gc�, �l�3� cq <br /> Applicant Signature Date <br /> Questions may be directed to the City Administration Office at 218-568-5222. <br /> Return Completed Applicarion to: City of Pequot Lakes <br /> City Administrator <br /> 4638 Main Street <br /> Pequot Lakes, MN 56472 <br /> E-mail: nmalecha(a��equotlakes-mn.�ov <br /> Website: www.pequotlakes-mn.gov <br /> OFFICE USE ONLY <br /> The Applicant is: � New Applicant Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to• <br /> Date Appointed• <br /> Term Ezpires• � <br /> S:�Administration\City C1erk�Boazds and Commissions�Application Process and Fo:ms�FormsWpplication Form for Boards and Commissions.doc <br /> Page 3 <br />