Laserfiche WebLink
For all munldpal business Iloinse questions, wmatt: city of Soul Bend • Department of Community Investment <br />227 WeftJefferson BW • Suite 14005 •Sautb Bend, Indiana 45641 • 574,235.5912 • F.514,235.9021 <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION -4-35 <br />Ill. OWNERSHIP <br />A. Type of ownership ¢ckone): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (If partnership, proceed to 2). <br />Corporation (If corporation., proceed to 3). <br />1. Sole Proprietor <br />Name:trn giro 4Er_ <br />Residential Address: <br />City: 1 tAHFtlt t G . State: \ Zip: �AvL <br />2. Partnership (List at least two (2) partners) <br />Name #1: <br />Residential Address: <br />City: State: Zip: <br />Name #2: <br />Residential Address: <br />City: State: Zip: <br />3. Corporation <br />Legal name of corporation: <br />Date and state of incorporation: <br />List officers and directors who own 15%or more of stock: <br />Name#1: <br />Title: <br />Business Address: <br />City: State: Zip: <br />Residential Address: <br />City: State: Zip: <br />Name #2: <br />Title: <br />Business Address: <br />City: State: Zip: <br />Residential Address: <br />City: State: Zip: <br />2 <br />