Taxi Company License Application

License Application for - Taxi Company

South Bend Municipal Code: Section 4-61
Full rules and regulations can be found in the South Bend Municipal Code: Section 4-61

Questions?

For all municipal business license questions, contact:

City of South Bend

Department of Community Investment

215 S. Dr. Martin Luther King Jr. Blvd.

Suite 500
South Bend, Indiana 46601

Phone: 574.235.5912

Fax: 574.235.9021

Application Type
Is this application pertaining to a new business or are you renewing your existing permit?
Business Data
Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does Mailing address differ from Property Address?
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Business Email Address
example@example.com
What is the net worth of the business? (assets minus debts)
List all unpaid judgements of the applicant and the circumstances giving rise to such judgement, along with the court and case number of each case where judgement was entered.
Have you ever operated a taxi business prior to this operation?
Was your permit to operate ever revoked or suspended?
Give Details
State your past experiences in the business of public passenger transportation
What facts do you believe support the need for an additional cab service in the City of South Bend?
Provide a list of all vehicles to be operated by this business (owned and leased). Include Taxi Cab Vehicle Plate Number, Year, Make and Model, Color, Passenger Capacity, VIN Number, and State License Plate Number

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Provide a list of all your drivers that drive for you and their vehicles numbers. Include their full name and ALL Taxi Cab Vehicle numbers that each individual will be driving.

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Describe the color scheme, identifying design, monogram, or insignia to be used to designate vehicles.
If applicable, upload the design.

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Will a 24-hour dispatch and service be provided to all locations within the City of South Bend?
Please note: Twenty-four hour services must be provided to all locations within the City for the Company to be licensed under Secion 4-61.
Insurance Carrier, agency, and Amount of Liability Insurance
Insurance Certificate

Policy must provide a 15 day cancellation notice to the City of South Bend
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Complete Rate and Hour Schedule

Please attached a sheet of your rates of fare, including all meter rates, flat rates, or any special rates your company intends to charge during the license year.
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Copy of your filled-out placard

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Note: no company may charge a rate that has not first been submitted in writing to the Central Services Division. If the Company intends to change its rates during the license term, the company must first give written notice to, and verify receipt by, the Central Services Division.
Personal Data
Applicant's Legal Name

First NameMiddle NameLast Name
Applicant's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant's Email
example@example.com
Applicant's Position with Organization
Applicant's Driver's License Number
Upload a copy of your driver's license

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Have you ever been convicted of a felony?
Specify date and circumstances
Have you ever been convicted of a misdemeanor?
Specify date and circumstances
Have you ever been convicted of a traffic or speeding violation?
Specify date and circumstances
Has your drivers or chauffeur's license ever been revoked?
Specify date and circumstances
Has your drivers license ever been suspended?
Specify date and circumstances
Ownership
Type of Ownership
Owner's Legal Name

First NameMiddle NameLast Name
Owner's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Owner's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Owner's Email
example@example.com
Partner 1's Legal Name

First NameMiddle NameLast Name
Partner 1's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Partner 1's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Partner 1's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Partner 1's Email
example@example.com
Partner 2's Legal Name

First NameMiddle NameLast Name
Partner 2's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Partner 2's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Partner 2's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Partner 2's Email
example@example.com
Legal name of Incorporation
State of Incorporation
Date of Incorporation

MonthDayYear
Resident Agent's Name

First NameMiddle NameLast Name
Resident Agent's Title
Resident Agent's Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Resident Agent's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Resident Agent's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Resident Agent's Email
example@example.com
Officer 1's Name

First NameMiddle NameLast Name
Officer 1's Title
Officer 1's Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 1's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 1's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 1's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 1's Email
example@example.com
Officer 2's Name

First NameMiddle NameLast Name
Officer 2's Title
Officer 2's Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 2's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 2's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 2's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 2's Email
example@example.com
Officer 3's Name

First NameMiddle NameLast Name
Officer 3's Title
Officer 3's Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 3's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Officer 3's Home Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 3's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Officer 3's Email
example@example.com
Signature
I, hereby, certify and affirm that all the information I have given in this application is true and accurate to the best of my knowledge. I further certify that I have in no way attempted to mislead the City in this application by omitting facts known to me. I have read and understand the regulations of the taxi cabs as found in The City of South Bend Municipal Code Section 4-61
Electronic Signature

First NameLast Name
Date

MonthDayYear
Should be Empty:

License Application for - Taxi Company

Questions?

Application Type

Business Data

Personal Data

Ownership

Signature