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 intcres 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 />Apicant Signature bate <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 />Email: sneine @vccwotlakes- mn.Rov <br />4Yebsite: wwwxcpuotlakes- mn.aov <br />! l} ��y' err�rlt�kerriz��a, ��i' Lh:=: M; a�a�, ��rrX' Is�yi��isinsn. �iairil�i[:; aiiiir��Yilx :a����:i.'a�►,v��'1 r�r'�i�jl�irrnl�r�'hz�Y±'lalli <br />OFFICE USE ONLY <br />The Applicant is: <br />Council Action <br />- Notes: <br />New Applicant Applying for Reappointment <br />Not Appointed <br />Appointed to: <br />Date Appointed; <br />Term Expires: <br />i <br />C:1Documeas and SettinzAnmalech ALoc d Seitin`s\Temporary Intemet Hesk=4\Applica tiun Fonn for Boards- and Commiscions.doc <br />Page 3 <br />