Laserfiche WebLink
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 />Appficant Signature i Date <br />Questions may be directed to the City Clerk's office at 218 -568 -5222. <br />Return Completed Application to: <br />City of Pequot Lakes <br />City Clerk <br />4638 County Road 11 <br />Pequot Lakes, MN 56472 <br />E:mail: sueine i ,peciuotlakes- inn.aov <br />Website: www.t)eQuotlakes- mn.zov <br />�ihy9lw trlr�4 ................. ' k` �a: 4�Lre�n�11' r .�ra�'i�a�hla�li <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 Expires: <br />Notes: <br />SASandy DocumentslCity CleMBoards and CommissionslApplication Process and Foms\Application Form for Hoards and Commissions.doc <br />Page 3 <br />