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3 <br />For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br />LICENSE APPLICATION FOR – CHARITABLE SOLICITATION <br />MUNICIPAL CODE SECTION - 4-55 <br />III.CHARITABLE SOLICITATION INFORMATION (Continued) <br />E.Will a professional fund raising consultant or professional solicitor be used? <br />NO (Skip to Section IV) <br />YES (State the name and address of the professional consultant/solicitor) <br />1.Professional’s name: <br />2.Business Address: <br />City:State: Zip: <br />IV.FINANCIAL INFORMATION <br />A.Estimated total amount of funds to be raised: <br />B.Expenses: <br />1.Salaries/Commissions: <br />2.Merchandise/Entertainment: <br />3.Promoter’s Fees: <br />4.Printing: <br />5.Rent: <br />6.Office Expenses: <br />7.Other: <br />Total Expenses: <br />C.Estimated percentage of solicited funds to be used directly for charitable work: <br />D.Estimated percentage of solicited funds that will be retained in the City: <br />E.Name(s) and address(s) of organization(s) receiving disbursements from the proposed <br />solicitation: <br />Name Address