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3 <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 /> <br /> <br />LICENSE APPLICATION FOR – CHARITABLE SOLICITATION <br />MUNICIPAL CODE SECTION - 4-55 <br />III. CHARITABLE SOLICITATION INFORMATION (Continued) <br />E. Will a professional fund-raising consultant or professional solicitor be used? <br />NO (Skip to Section IV) <br />YES (State the name and address of the professional consultant/solicitor) <br />1. Professional’s name: <br />2. Business Address: <br />City: State: Zip: <br />IV. FINANCIAL INFORMATION <br />A. Estimated total amount of funds to be raised: <br />B. Expenses: <br />1. Salaries/Commissions: <br />2. Merchandise/Entertainment: <br />3. Promoter Fees: <br />4. Printing: <br />5. Rent: <br />6. Office Expenses: <br />7. Other: <br />Total Expenses: <br />C. Estimated percentage of solicited funds to be used directly for charitable work: <br />D. Estimated percentage of solicited funds that will be retained in the City: <br />E. Name(s) and address(s) of organization(s) receiving disbursements from the proposed <br />solicitation: <br />Name Address <br /> <br /> <br />