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 interest 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 />, <br />�` �'� �- � <br />,�,� ��� � ,��� � � <br />�� o,���-� � /'� �-��� ,�� , , ,�� ,�° � <br />Applicant Signature � Date <br />Questions may be d'arected 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 />E:mail: sbeineC�pec�uotlakes-mn.�ov <br />Website: www.pequatlakes-mn.�ov <br />Thi.� nppGee�tio�i wil/ be kept or2 fi/e,f'or o�1e vecii; ctf'ter tlzctt tirne n fzc �• aE�l�liccatiun nru.st /�e,frled. <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 Elcpires: <br />� <br />C:�Documents and Settings\nmalecha\I.ocal Settings\Temporary Intemet Files\OLK4\Applicntion Form for Boards and Commissions.doc <br />Page 3 <br />