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Conflict of Interest is defined as the participation in any activity, recorn mended 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),business, <br /> however organized,which could be construed as a conflict of interestTles MNo <br /> If yes,provide details on a se &rate pjece of paper. <br /> 1/28/2015 <br /> Applicant Signature Date <br /> Questions may be directed to the Administration Department at 763.635.1000. <br /> This application be b on for 1application <br /> must be 1 <br /> OFFICE USE ONLY <br /> ❑ New Applicant ❑ Reappointment <br /> C',ounCil Meeting Date: <br /> ❑ Appointed to: <br /> 'term Fxpires: <br /> ❑ Not Appointed <br />