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For all municipal business license pue skin, mntad: MaSouM Bend • BepanmemnfCommunity Investment <br />227 We Ueffenon Bled • Suite I400S -South Bend, Indiana 46a01 a 574.235.59U • F. 574.235.Wa <br />LICENSE APPLICATION FOR -TRANSIENT MERCHANT <br />MUNICIPAL CODE SECTION -4-60 <br />II. BUSINESS DATA(Continued) <br />Q. Contact person to be responsible for customer complaints and available at least sizty(60) <br />days following last date of business: <br />Contact's Legal Name' <br />Kristen Sikorski-Conklin <br />Residential Address: <br />City: South Bend State: IN zip NOW - <br />Telephone Number: 574250-5086 <br />III. PERSONAL DATA (Applicant) <br />A. Applicant's Legal Name: Kristen Sikorski-Conklin <br />B. Residential Address: <br />City. South Bend State: IN Zip: <br />C. Residential Telephone Number: NIA <br />D. Cellphone Number: <br />E. Position with business: Fair Board President <br />F. Social Security Number: <br />G. Gender <br />H. Date of birth: <br />I. Race: <br />IV. PERSONAL DATA (Owner, if differs) <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. Position with business: <br />F. Social Security Number: <br />G. Gender: <br />H. Date of birth: <br />1. Race:. <br />2 <br />