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1 <br />For all municipal business license questions, contact: City of South Bend • Department of Community Investment <br />215 S. Dr. Martin Luther King Jr. Blvd. • Suite 500 <br />South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 <br />LICENSE APPLICATION FOR – VEHICLE REMOVAL SERVICE <br />MUNICIPAL CODE SECTION – 4-20.5 <br />I.APPLICATION TYPE Check One:New Renewal <br />II.BUSINESS DATA <br />A.Business Name: <br />B. Business Address: <br />City: State: Zip: <br />C.Mailing Address (If different from above): <br />City: State: Zip: <br />D.Business Telephone Number: <br />E.Business Fax Number: <br />F.E-Mail Address: <br />G.Insurance Carrier, Agent, and Amount of Liability Insurance: <br />III.PERSONAL DATA <br />A.Applicant'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 />For Office Use Only <br />Application Filed Fire Dept. Approval <br />Application Fee Paid Police Dept. Approval <br />Sent to Dept. License Fee Paid <br />Code Enforcement Approval License Number <br />Not Approved <br />Reason