Federal Communications Commission
Washington, D.C. 20554
Approved by OMB
3060-0010 (June 2002)
FCC 323
FOR FCC USE ONLY
 
OWNERSHIP REPORT FOR COMMERCIAL BROADCAST STATIONS

Read INSTRUCTIONS Before Filling Out Form

FOR COMMISSION USE ONLY
FILE NO.

BON - 20041130AFV
Section I - General Information
1. Legal Name of the Applicant 
STARBOARD MEDIA FOUNDATION, INC.
Mailing Address
PO BOX 13213
City
GREEN BAY
State or Country (if foreign address)
WI
ZIP Code
54307 - 3213
Telephone Number (include area code)
8882333021
E-Mail Address (if available) 
FCC Registration Number:
0005032248
Call Sign 
WAUR
Facility ID Number 
1131
2. Contact Representative (if other than Licensee/Permittee)
DENISE B. MOLINE, ESQ.
Firm or Company Name
DENISE B. MOLINE, ESQ.
Telephone Number (include area code)
6307530112
E-Mail Address (if available)
DBMOLINE@WOWWAY.COM
3. Name of entity, if other than licensee or permittee, for which report is filed

Mailing Address


City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
E-Mail Address (if available)
4. If this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114):
Governmental Entity Fee-exempt Report Other NON FEEABLE
N/A (Fee Required)



Section II - Ownership Information

5.

a. Biennial b. Transfer of Control or Assignment of License/Permit c. Other
d. Amendment to pending application


for the following stations:

[Enter Station Information]


Station List


This Report is filed for the following stations:

Call Letters
Facility ID Number
Location (City/State)
Class of service
WAUR 48240 SANDWICH IL AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WJOK 19879 KAUKAUNA WI AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WZRK 61389 LAKE GENEVA WI AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WHFA 54617 POYNETTE WI AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WDVM 1131 EAU CLAIRE WI AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WMMA 4918 NEKOOSA WI FM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WYNW 87600 BIRNAMWOOD WI FM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WPJP 73051 PORT WASHINGTON WI FM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WKBH 56617 HOLMEN WI AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
WLOL 42963 MINNEAPOLIS MN AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
KSMM 49307 SHAKOPPEE MN AM



All of the information furnished in this Report is accurate as of 11/30/2004 (Date must comply with 47 C.F.R. Section 73.3615(a), i.e., information must be current within 60 days of filing of this report, when 5(a) below is checked.)

This Report is filed for (check one)
6.
Respondent is:
Sole proprietorship Not-for-profit corporation Limited partnership
For-profit corporation General partnership Other
If "Other", describe nature of the respondent in an Exhibit.
[Exhibit 1]
7.
List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613.   (Only licensees, permittees, or a reporting entity with a majority interest in or that otherwise exercises de facto control over the subject licensee or permittee shall respond.)

[Enter Contract/Instrument Information]


Contracts/Instruments Information


List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613. (Only licensees, permittees, or a reporting entity with a majority interest in or that otherwise exercises de facto control over the subject shall respond.)

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration
ARTICLES OF INCORPORATION STATE OF WISCONSIN 08/01/2000

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration
ARTICLES OF AMENDMENT STATE OF WISCONSIN 03/03/2001

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration
ARTICLES OF AMENDMENT STATE OF WISCONSIN 11/01/2002

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration
BY-LAWS DIRECTORS 04/18/2001


8. Capitalization (Only licensees, permittees, or a reporting entity with a majority interest in or that otherwise exercises de facto control over the subject licensee or permittee shall respond.)

[Enter Capitalization Information]



9.
(a.) List the respondent, and, if other than a natural person, its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. If a corporation or partnership holds an attributable interest in the respondent, list separately its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. Create a separate row for each individual or entity. Attach supplemental pages, if necessary.
[Enter Owner Information]

Owner Information

List the respondent, and, if other than a natural person, its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. If a corporation or partnership holds an attributable interest in the respondent, list separately its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. Create a separate row for each individual or entity. Attach supplemental pages, if necessary.
(Read carefully - The numbered items below refer to line numbers in the following table.)
1. Name and address of respondent and each party to the respondent holding an attributable interest (if other than individual also show name, address and citizenship of natural person authorized to vote the stock or holding the attributable interest). List the respondent first, officers next, then directors and, thereafter, remaining stockholders and other entities with attributable interests, and partners.
2. Gender (male or female).
3. Ethnicity (check one).
4. Race (select one or more).
5. Citizenship.
6. Positional interest: Officer, director, general partner, limited partner, LLC member, investor/creditor attributable under the Commission's equity/debt plus standard, etc.
7. Percentage of votes.
8. Percentage of total assets (equity debt plus).

1. Name and Address STARBOARD MEDIA FOUNDATION, INC., 2300 RIVERSIDE DR., GREEN BAY, WI 54301
2. Gender (male or female)
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest NONE
7. Percentage of votes 0.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address MARK C. FOLLETT, PO BOX 10707, GREEN BAY, WI 54307-0707
2. Gender (male or female) Male
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest CHAIRMAN AND CEO
7. Percentage of votes 25.00
8. Percentage of total assets (equity debt plus) 73.00

1. Name and Address JOHN CAVIL, 2727 S. KENLAR CIR., GREEN BAY WI 54313
2. Gender (male or female) Male
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest DIRECTOR
7. Percentage of votes 25.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address ROBERT ATWELL, 3225 DELAHAUT ST., GREEN BAY, WI 54301
2. Gender (male or female) Male
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest DIRECTOR
7. Percentage of votes 25.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address MICHAEL S. ARIENS, N7449 ROUND LAKE ROAD, BRILLION, WI 54301
2. Gender (male or female) Male
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest DIRECTOR
7. Percentage of votes 25.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address GERALD L. MOORE, 244 CAVIL WAY, DEPERE, WI 54115
2. Gender (male or female) Male
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest TREASURER
7. Percentage of votes 0.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address MARGARET ROSE SNOREK, 707 EDGE POINT COURT, DEPERE, WI 54115
2. Gender (male or female) Female
3. Ethnicity (check one) Hispanic or Latino
Not Hispanic or Latino
4. Race (select one or more) American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
5. Citizenship US
6. Positional Interest SECRETARY
7. Percentage of votes 0.00
8. Percentage of total assets (equity debt plus) 0.00


(b) Respondent certifies that equity and financial interests not set forth in response to Question 9(a) are non-attributable. Yes No

N/A

See Explanation in
[Exhibit 2]

(c) Is the respondent or any party holding an attributable interest in the respondent also the holder of an attributable interest in any other broadcast station or in any cable or newspaper entities in the same market or with overlapping signals in the same broadcast service, as described in 47 C.F.R. Sections 73.3555 and 76.501? Yes No
If "Yes", submit an Exhibit identifying the holder of that other attributable interest, listing the call signs, locations and facilities identifiers of such other broadcast stations, and describing the nature and size of the ownership interest and the positions held in the other broadcast, cable or newspaper entities. [Exhibit 3]
(d) Are any of the individuals listed in response to Question 9(a) related as parent-child, husband-wife, brothers and sisters?

Yes No

 

If "Yes", submit an Exhibit setting forth full information as to the family relationship

[Exhibit 4]

(e) Is respondent seeking an attribution exemption for any officer or director with duties unrelated to the licensee or permittee?

If "Yes", submit an Exhibit identifying that individual by name and title, fully describing that individual's duties and responsibilities, and explaining why that individual should not be attributed an interest.

Yes No

[Exhibit 5]



SECTION III - CERTIFICATION


I certify that I am CHAIRMAN

(Official Title)


of STARBOARD MEDIA FOUNDATION, INC.

(Exact legal title or name of respondent)


and that I have examined this Report and that to the best of my knowledge and belief, all statements in this Report are true, correct and complete.

(Date of certification must be within 60 days of the date shown in Question 5, Section II and in no event prior to that date.)

Signature
MARK C. FOLLETT
Date
11/30/2004
Telephone Number of Respondent (Include area code) 9204693021

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).



Exhibits
Exhibit 3
Description:
ATTRIBUTABLE INTERESTS

STARBOARD MEDIA FOUNDATION, INC. IS THE LICENSEE OF STATIONS WLOL (AM) MINNEAPOLIS, MN #42963 AND KSMM (AM), SHAKOPEE, MN,#49307 BOTH OF WHICH ARE IN THE ARBITRON-RATED MINNEAPOLIS, MN MARKET. THERE ARE 22 AM STATIONS AND 20 FM STATIONS IN THE MINNEAPOLIS MARKET. ACCORDINGLY, LICENSEE IS IN COMPLIANCE WITH THE FCC'S DUOPOLY RULES AS SET FORTH IN SECTION 73.3555.

Attachment 3