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For all municipal business license quest'ons, contact: City of South Bend - Department of Community Investment <br />227 West Jefferson Bled • Suite 14005 -South Bend, Indiana 46601 • 574.235.5912 • F: 574,235,9021 <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION - 4-35 <br />JII.OWNERSHIP <br />A. Type of ownership (check one): <br />Sole Proprietorship (If sole proprietorship, proceed to 1). <br />Partnership (If partnership, proceed to 2). <br />Corporation (If corporation, proceed to3). <br />1. Sole Proprietor <br />Name: I <br />Residenti; <br />City: 4 <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 IS% 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 />Tit le: <br />Business Address: <br />Crty. State: Zip. - <br />Residential Address: <br />City: State: Zip: <br />2 <br />