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Conflict of Interest is defined as the participation in any activity, recommended action, or decision <br />froth which the individual has or could have the potential to rcceive 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 interestrD'es ✓JNO <br />If ves, provide details on a sc araretp cc.e of paper. <br />1/21/2016 <br />Appl` nt Signature Date <br />Questions may be directed to the Administration Department at 763.635.1000. <br />OFFICE USE ONLY <br />Ne«r Applicant <br />Council .Meeting Date: <br />CI Reappointment <br />0 appointed to - <br />Term Expires: <br />G Not Appointed <br />