Laserfiche WebLink
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 – PRECIOUS METALS DEALER <br />MUNICIPAL CODE SECTION – 4-44 <br /> <br /> <br />IV. OWNER’S PERSONAL DATA <br /> <br />A. Owner’s Legal Name: <br />B. Residential Address: <br />City: State: Zip: <br />C. Residential Telephone Number: <br />D. Cellphone Number: <br />E. Social Security Number: F. Gender: <br />G. Date of Birth: H. Race: <br /> <br />V. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br /> <br />VI. AFFIRMATION <br /> <br />I, hereby, certify and affirm that all of the information I have given in this application is true and <br />accurate to the best of my knowledge. I further certify that I have in no way attempted to <br />mislead the City in this application by omitting facts known to me. I have read and understand <br />the regulations of the Precious Metals Dealer license found in the City of South Bend Municipal <br />Code, Section 4-44. <br /> <br /> <br /> <br /> <br />Signature Date