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For all municcal business license questions, content: City ofSouN Bone! • Department of rnmmunhy Irn¢[ment <br />227W6tlethrson BNtl • Sune 14MS •Soutr Bend, Indiana 46601 • 57C235.5912 • F.514215.9021 <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION - 4-35 <br />III.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 to 3). <br />1. Sole Proprietor <br />Name: MEI LI SUN WENDELL SHELDON <br />Residential Address: 14535 DAY RD. <br />Cam. MISHAWAKA State: IN Zip: 46545 <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 />