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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 intereo 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 />�1ppl�n Signattl ' 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 55472 <br />Email: saeine,lt�,t)ertuotlakes- nin.srov <br />Website: r�,wiv.pcciuotl,,kes- nur.�zov <br />OFFICE USE ONLY <br />The Applicant is: <br />Council Action: <br />Notes: <br />New Applicant <br />Not Appointed <br />Appointed to: <br />Date Appointed: <br />Term Expires: <br />htrp;I lv vww. pegviotlakes- mn .govlvcrlital/sites/(B607A &OF•A F01.4CO6 -A4 D7- <br />F7DF956555131)Iaploads /Application_Forisi_for Boards and_CoinurissionsAoo <br />Page 3 <br />_Applying for Reappointment <br />