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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 />2 <br /> <br /> <br /> <br /> <br /> <br />LICENSE APPLICATION FOR – FOOD VENDING VEHICLE <br />MUNICIPAL CODE SECTION - 4-25 <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 /> <br />IV. INCLUDE COPY OF CURRENT LIABILITY INSURANCE POLICY WITH APPLICATION <br /> <br />V. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br /> <br />VI. AFFIRMATION <br /> <br />I, hereby, certify and affirm that all 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 have read and understand <br />the regulations of the Food Vending Vehicle license found in the City of South Bend Municipal <br />Code, Section 4-25. <br /> <br /> <br /> <br /> <br />Signature Date