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2 <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 /> <br />LICENSE APPLICATION FOR - MASSAGE THERAPIST <br />MUNICIPAL CODE SECTION - 4-35 <br /> <br />II. PERSONAL DATA (Continued) <br />L. Photographs: <br />Attach below (3) Passport photos, 1"x1", taken within 6 months of the date of this application. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />M. Please list all criminal convictions including ordinance violations (if any), excluding traffic <br />violations: <br />Nature of Conviction City State Date <br /> <br /> <br /> <br />(Attach additional sheets if necessary) <br /> <br />N. Please list all previous employment for three (3) years prior to the date of this application: <br />Company Address City, State, ZIP Dates <br /> <br /> <br /> <br />(Attach additional sheets if necessary)