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<br />Conflict of Interest is defined as the participation in any activity, recommended 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 any business, " <br />however organized, which could be construed as a-conflict of interest? ^ Yes ^ No <br />If yes,. provide details-. on a se axate iece of baker: <br />Z ~ <br />4Applicant Signature Date <br />Questions may be directed to the Administration Department at 763.635:1000. <br />OFFICE USE ONLY __ <br />^ New Applicant ^ Reappointment <br />Council Meeting Date: <br />^ Appointed to: <br />Term Expires: <br />Not Appointed <br />