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Comments: �()� �/j �� � �� � V�, e� , <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 /> � - <br /> �� '� 7 -�/ <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�pequotlakes-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 E�rpires• <br /> S Wdministration\C�ty Clerk�Boards and ComuussionsWpplication Proccss and Forms�ForauWppLcation Fortn for Boards and Comm�ssions doc <br /> Page 3 <br />