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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 construed as a conflict of <br /> interest? Yes �No <br /> If yes, provide details on a separate piece of paper. <br /> � �.�. _ c, /� . �4! `� <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: nmalecha(a�pec�uotlakes-mn.�ov_ <br /> Website: www.pequotlakes-mn.�ov <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 Wdmuustration\C�ty Clerlc�Boards and Comm�ssionsWppl�catan Prce�ss and Forms�FormsWpplicahon Fom for Boards and Comm�ss�ons doc <br /> ParrP Z <br />