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� <br />� <br />� <br />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 equita.ble interest ' 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 />��/I.,Gi /� �.J/A/Yl.[,C'`�J�J `7 ' �d' / � <br />�� - � - <br />Applicant Signature Date <br />Questions may be directed to the City Clerk's office at 218-568-5222. <br />Return Completed Application to: <br />OFFICE USE ONLY <br />The Applicant is: <br />Council Action: <br />Notes: <br />City of Pequot Lakes <br />City Clerk <br />4638 County Road 11 <br />Pequot Lakes, MN 56472 <br />E:ma�i: sneine(a�aec�uotlakes-mn.�ov <br />Website: WWW.peauotlakes-mn.�ov <br />New Applicant <br />Not Appointed <br />Appointed to: <br />Date Appointed: <br />Term Eapires: <br />Applying for Reappointment <br />� <br />