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For all munIdpal business license questons, mntaot: City of South Bend • Department of Community Investment <br />227 West Jefferson BIM • Suite 1400 S -South Bend, Indiana G6601 •5)A235.5912 • F: 574335.9021 <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 tol). <br />Partnership (If partnership, proceed to 2(. <br />Corporation (If corporation, proceed to 3). <br />1. Sole Proprietor <br />Name: S i 0.n L_u <br />Residential Address: <br />City: State: Zip: <br />2. Partnership (List at least two (2( partners( <br />Name #1: <br />Residential Address: <br />City: State: Zip: <br />Name N2: <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 Rl: <br />Title: <br />Business Address: <br />City: State: Zip: <br />Residential Address: <br />City: State: Zip: <br />Name#2: <br />Tile: <br />Business Address: <br />City' state: Zip'. <br />Residential Address: <br />City: State: Zip: <br />2 <br />