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Conflict of Interest is defined as the participativn in am activitS-, 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 accvrdance with this definition, d.v ~=ou have ant legal yr equitable interest in an business, <br />ho~vec~er orgazuzed, tuhich cr3uld be construed as a c<.>nflict of interest~~'es ~No <br />Ify=es, provide details on. a se. arate irce ~~f gaper, <br />Applicant Signature Date <br />Questions mad be directed to the Administration Department at 7G3.63S.10U0. <br />OFFICE USE ONLY <br />~1e~v Applicant ^ Reappointment <br />Council Fleeting Date: <br />Appointed: tv: <br />'T'erm Elpires: <br />^ l~lvt ~~ppvinted <br />