Laserfiche WebLink
Conflict of Interest is defined as the participation in any activity, recoaunended 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"? X Yes No 1�-5 !� <br />If yes, provide details on a separate piece of paper. A��"'� '�� °.►�e,�r /''% Ili' <br />�i <br />Il'r121 � z <br />Applicant Signature Da�lr <br />Questions may be directed to the City Clerk's office at 218 -568 -5222. <br />Return Completed Application to: City of Pcquot Lakes <br />City Clerk <br />4638 County Road I I <br />Pcquot Lakes, MN 56472 <br />Email: soeine@ueciuotlakes- mn.aov <br />Website: wwwj)cquotlakes- mnjzov <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 />C:\Documcnts and Sa6ngs\ m 1cchaU -ocal SatingATemporary In[emet Fi OOLK4Upplication Form for Boards and Commissir ms,doe <br />Page 3 <br />