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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. (Sec 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 interesr�D'es ✓ZNo <br /> If yes, provide details on a se_ a= rate ip ece caf 12a er. <br /> 9/17/2014 <br /> Ap licant Signature Date <br /> Questions may be directed to the Administration Department at 763.635.1000. <br /> This application will • - kept on • one T•4CFll <br /> must b%fil <br /> re- <br /> OFFICE USE ONLY <br /> ❑ New Applicant ❑ Reappointment <br /> Council Meeting Date: <br /> ❑ Appointed. to: <br /> Term Expires <br /> ❑ Not Appointed <br />