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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 /> <br />For Office Use Only <br /> <br />Application Filed Police Dept. Approval <br />Application Fee Paid ($5) Fire Dept. Approval <br />Sent to Dept. License Fee Paid ($75) <br />License Number <br /> <br />Not Approved <br />Reason <br />LICENSE APPLICATION FOR - ALARM AGENT <br />MUNICIPAL CODE SECTION - 4-18.7 (SEE ALSO 12.1) <br /> <br />I. APPLICATION TYPE Check One: New Renewal <br /> <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. Number of Clients: <br />H. All-hours Telephone Number: <br /> <br />III. PERSONAL DATA (Required for the background check performed by the South Bend Police Department) <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. Social Security Number: F. Date of birth: <br />F. Position with the Organization <br /> <br /> <br /> <br />