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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?Dyes WINO <br /> If yes,pr vid details o a se arate piLce of 12aper. <br /> " 2/6/13 <br /> Ap lif Signatu 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 /> i <br /> i <br />