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Conflict of Interest is defined as the participation in any activity, recorrunended action, or decision <br />from which the individual has or could have the potential to receive personal gain, whether it be <br />direct or indirect. (See attached "Conflict of Interest" Ordinance) <br />In accordance with this definition, do you have any legal or equitable interest in an usiness, <br />however organized, which could be construed as a conflict of interest? ^ Yes No <br />If yes, provide details on a separate iece of gaper. <br />aY ~ ~ <br />Applicant Signature Date <br />Questions may be directed to the Administration Department at 763.635.1000. <br />OFFICE USE ONLY <br />Council Meeting Date: <br />^ Appointed to: <br />Term Expires: <br />^ Not Appointed <br />