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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 interst in any business which could be construed as a conflict of <br /> interest? Yes X No <br /> If yes, provide details on a separate piece of paper. <br /> y7/ ► ' --- <br /> / / //1/ <br /> Applicant Signature Date <br /> Questions may be directed to the City Clerk's office at 218-568-5222. <br /> Return Completed Application to: City of Pequot Lakes <br /> City Clerk <br /> 4638 County Road 11 <br /> Pequot Lakes, MN 56472 <br /> E:mail: speine @pequotlakes-mn.gov <br /> Website: www.pequotlakes-mn.gov <br /> This application wilt be kepi ut7 tilt pl.one rear: atici.That link:a nets application 1111v! /ic idecl. <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:\Users\jtuil\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\7OLSFKOZ\Application Form for Boards and <br /> Commissions.doc <br /> Page 3 <br />