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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 individua.l has or could have the potential to receive personal <br /> gain,whether it is direct or indirect. In accorda.nce with this definition, do you have any <br /> legal or equitable interes 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 /> � <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,pequotlakes-mn.gov <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 CommissionsWpplication Pmcess and Forms�Foims�Application Form for Boards and Commissions.doc <br /> Page 3 <br />