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5 <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 – TATTOO & BODY PIERCING ARTIST <br />MUNICIPAL CODE SECTIONS – 13-125 – 13-152 <br />V.INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br />VI. AFFIRMATION <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 agree to cooperate with any <br />review conducted pursuant to the licensing procedures, including permission to enter and <br />inspect the place of business and facilities in conjunction with such a review. I have read and <br />understand the regulations Tattoo Establishments and Technicians found in the City of South <br />Bend Municipal Code, Sections 13-125 – 13-152. <br />Signature Date <br />PLEASE NOTE: Filing of new application for license does NOT authorize conducting Tattoo Artist <br />Business until such license has actually been issued to applicant.