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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 conshued as a conflict of <br /> interest? Yes �No <br /> If yes,provide details on a separate piece of paper. <br /> 1 Z-,�� -i� <br /> li t Si e 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�pequotlakes-mn.� <br /> Website: www.pequotlakes-mn.� <br /> OFFICE USE ONLY <br /> The Applicant is: New Appiicxnt Applying for Reappointment <br /> Council Action: Not Appointed <br /> Appointed to• <br /> Date Appointed• <br /> Term E�cpires• <br /> S:Wdministretiou\City Ckrk�Boards and Commiss�ons�Application Process and Forms�FormsUpphcation Fortn for Boards and Comrsussions.doc <br /> Page 3 <br />