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8.1 EDSR 12-19-2016
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8.1 EDSR 12-19-2016
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12/16/2016 4:14:36 PM
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12/16/2016 4:14:35 PM
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City Government
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EDSR
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12/19/2016
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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? ❑Yes Ai No <br /> If yes • •• • a i.. ,to piece paper. <br /> _ Amailiti Zig"' V2� <br /> 1p• i canMr. a Date <br /> Questions may be directed to the Administration Department at 763.635.1000. <br /> This application will be kept on file for one year; after that time a new application <br /> r-rust be filed. <br /> OFFICE USE ONLY <br /> The Applicant is: ❑ New Applicant ❑ Applying for Reappointment nt <br /> Council meeting date: <br /> ❑ Appointed to: <br /> Term Expires: <br /> ❑ Not Appointed <br />
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