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.

BOA - 20051114AAQ
Section I - General Information
1. Legal Name of the Applicant 
BUSTOS MEDIA OF OREGON LICENSE, LLC
Mailing Address
3100 FITE CIRCLE
City
SACRAMENTO
State or Country (if foreign address)
CA
ZIP Code
95827 -
Telephone Number (include area code)
9163686332
E-Mail Address (if available) 
ABUSTOS@BUSTOSMEDIA.COM
FCC Registration Number:
0012852620
Call Sign 
Facility ID Number 
2431
2. Contact Representative (if other than Licensee/Permittee)
JOSEPH D. SULLIVAN
Firm or Company Name
LATHAM & WATKINS LLP
Telephone Number (include area code)
2026372200
E-Mail Address (if available)
JOE.SULLIVAN@LW.COM
3. Name of entity, if other than licensee or permittee, for which report is filed
PROVIDENCE GROWTH ENTREPRENEURS FUND, L.P.
Mailing Address
C/O JOHN WOODWORTH, III
50 KENNEDY PLAZA

City
PROVIDENCE
State or Country (if foreign address)
RI
ZIP Code
02903 -
Telephone Number (include area code)
4017516754
E-Mail Address (if available)
J.WOODWORTH@PROVEQUITY.COM
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
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
KXMG 71752 PORTLAND OR AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
KMUZ 51210 GRESHAM OR AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
KGDD 2431 OREGON CITY OR AM


Call Letters
Facility ID Number
Location (City/State)
Class of service
KZNY 68212 MILWAUKEE OR AM



All of the information furnished in this Report is accurate as of 11/11/2005 (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
N/A


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]


Capitalization


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

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
N/A


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 PROVIDENCE GROWTH ENTREPRENEURS FUND, L.P., C/O PROVIDENCE EQUITY PARTNERS, INC., 50 KENNEDY PLAZA, 18TH FLOOR, PROVIDENCE, RI 02903
2. Gender (male or female) N/A
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 RESPONDENT
7. Percentage of votes 0.00
8. Percentage of total assets (equity debt plus) 0.00

1. Name and Address PROVIDENCE GROWTH GP L.P., C/O PROVIDENCE EQUITY PARTNERS, INC., 50 KENNEDY PLAZA, 18TH FLOOR, PROVIDENCE, RI 02903
2. Gender (male or female) N/A
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 SOLE GENERAL PARTNER
7. Percentage of votes 100.00
8. Percentage of total assets (equity debt plus) 1.00

1. Name and Address INSULATED LIMITED PARTNERS
2. Gender (male or female) N/A
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 INSULATED LIMITED PARTNERS
7. Percentage of votes 0.00
8. Percentage of total assets (equity debt plus) 99.00


(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 LIMITED PARTNER OF SOLE GENERAL PARTNER

(Official Title)


of PROVIDENCE GROWTH ENTREPRENEURS FUND, L.P.

(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
MICHAEL J. DOMINGUEZ
Date
11/11/2005
Telephone Number of Respondent (Include area code) 4017510536

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:
EXHIBIT 3

BUSTOS MEDIA OPERATING, LLC IS CONTROLLED BY BUSTOS MEDIA, LLC. PROVIDENCE GROWTH INVESTORS, L.P. AND PROVIDENCE GROWTH ENTREPRENEURS FUND, L.P. ARE 39.021% AND 3.105% COMMON MEMBERS, RESPECTIVELY, OF BUSTOS MEDIA, LLC. THE SOLE GENERAL PARTNER OF PROVIDENCE GROWTH INVESTORS, L.P. AND PROVIDENCE GROWTH ENTREPRENEURS FUND, L.P. IS PROVIDENCE GROWTH GP, L.P.

THE SOLE GENERAL PARTNER OF PROVIDENCE GROWTH GP, L.P. IS PROVIDENCE GROWTH INVESTORS, LLC. ITS LIMITED PARTNERS ARE JONATHAN M. NELSON, GLENN M. CREAMER, PAUL J. SALEM, JONATHAN M. NELSON ASSOCIATES, LP, GLENN M. CREAMER ASSOCIATES, LP, PAUL J. SALEM ASSOCIATES, LP, MICHAEL J. ANGELAKIS, PETER WILDS, MICHAEL J. DOMINGUEZ, ALEXANDER D. EVANS, JULIE A. FISHER, MARK J. MASIELLO, MARK A. PELSON, RAYMOND M. MATHIEU, JONATHAN M. NELSON, GLENN M. CREAMER, ANGELAKIS CHILDRENS TRUST, JOHN HAHN GRANTOR TRUST, THE ANNE FARLOW LIFE INTEREST SETTLEMENT, BISWAJIT SUBRAMANIAN GRANTOR TRUST.

THE MEMBERS OF PROVIDENCE GROWTH INVESTORS, LLC ARE GLENN M. CREAMER (28.57%), JONATHAN M. NELSON (42.86%) AND PAUL J. SALEM (28.57%).

GLENN M. CREAMER, JONATHAN M. NELSON AND PAUL J. SALEM, MICHAEL J. DOMINGUEZ, MARK J. MASIELLO, MARK J. NOBLE HOLD THROUGH COMMONLY CONTROLLED INVESTMENT FUNDS, OTHER ATTRIBUTABLE INTERESTS IN THE FOLLOWING:

BLUESTONE LICENSE HOLDINGS, INC., LICENSEE OF:

WCYB-TV, ID # 2455, BRISTOL, VA
KTXS-TV, ID #308, SWEETWATER, TX
KRCR-TV, ID #8291, REDDING, CA
KAEF(TV), ID #8363, ARCATA, CA
KECI-TV, ID #18084, MISSOULA, MT
KCFW-TV, ID #18079, KALISPELL, MT
KTVM(TV), ID #18066, BUTTE, MT

FREEDOM BROADCASTING OF OREGON LICENSEE, L.L.C., LICENSEE OF:

KTVL(TV) ID #22570, MEDFORD, OR

FREEDOM BROADCASTING OF SOUTHERN NEW ENGLAND LICENSEE, L.L.C.,
LICENSEE OF:


WLNE-TV, ID #22591, NEW BEDFORD, MA

FREEDOM BROADCASTING OF FLORIDA LICENSEE, L.L.C., LICENSEE OF:

WPEC-TV, ID #52527, WEST PALM BEACH, FL

FREEDOM BROADCASTING OF TEXAS LICENSEE, L.L.C., LICENSEE OF:

KFDM-TV, ID #22589, BEAUMONT, TX

FREEDOM BROADCASTING OF TENNESSEE LICENSEE, L.L.C.. LICENSEE OF:

WTVC-TV, ID #22590, CHATTANOOGA, TN

FREEDOM BROADCASTING OF NEW YORK LICENSEE, L.L.C., LICENSEE OF:

WRGB-TV, ID #73942, SCHENECTADY, NY

FREEDOM BROADCASTING OF MICHIGAN LICENSEE, L.L.C., LICENSEE OF:

WWMT-TV, ID #74195, KALAMAZOO, MI
WLAJ-TV, ID #36533, LANSING, MI

BUSTOS MEDIA OF SEATTLE, LLC IS THE LICENSEE OF THE FOLLOWING:

KDDS(AM), ID #33683, AUBURN-FEDERAL WAY, WA
KAYO(FM), ID #33622, ELMA, WA

BUSTOS MEDIA OF EASTERN WASHINGTON, LLC IS THE LICENSEE OF THE
FOLLOWING:

KULE(AM)4041 EPHRATA, WA
KULE-FM4042 EPHRATA, WA
KZTB(FM)4758 BENTON CITY, WA
KZTA(FM)36006 NACHES, WA
KYXE(AM)64506 UNION GAP, WA
KZTS(AM)4757 SUNNYSIDE, WA
KZML(FM)15137 QUINCY, WA
KZML-FM1137979WENATCHEE, WA
K286BC139326EDGEMONT, WA
K285FN139179KENNEWICK WEST, WA
K225AR139113WENATCHEE, WA
K291AS139108MATTAWA, WA
K229AD82285YAKIMA, WA
K269EU139111ROYAL CITY, WA
K248BG139349ELLENSBURG, WA
KMMG(FM)78697WESTON, OR

BUSTOS MEDIA OF CALIFORNIA LICENSE, LLC IS THE LICENSEE OF
THE STATIONS LISTED BELOW.

KTTA(FM)51221 ESPARTO, CA
KBBU(FM)43335 MODESTO, CA
*KKFS(FM) 56366LINCOLN, CA
**KBAA(FM)87969GRASS VALLEY, CA
**KLMG(FM)24464JACKSON, CA

*BEING SOLD.
**BEING ACQUIRED AND OPERATING PURSUANT TO AN LMA

BUSTOS MEDIA OF UTAH LICENSE, LLC IS THE LICENSEE OF
THE STATIONS LISTED BELOW.

KXTA(AM),ID #69557, CENTERVILLE, UT
KDUT(FM), ID #88272, RANDOLPH, UT

ROCKY MOUNTAIN RADIO NETWORK, INC. IS THE LICENSEE OF
THE STATION LISTED BELOW.

KBMG(FM), ID #20029, EVANSTON, WY

BUSTOS MEDIA OF OREGON LICENSE, LLC IS THE LICENSEE
OF THE STATIONS LISTED BELOW.

KXMG(AM)71752 PORTLAND, OR
KMUZ(AM)51210 GRESHAM, OR
KGDD(AM)2431 OREGON CITY, OR
KZNY(AM)68212 MILWAUKEE, OR

BUSTOS MEDIA OF IDAHO LICENSE, LLC IS THE LICENSEE OF THE STATION
LISTED BELOW:

KDBI(FM), ID #54509, EMMETT, ID

BUSTOS MEDIA, LLC IS THE PROPOSED ASSIGNEE OF THE STATION LISTED BELOW:

*WDDW(FM)53506 STURTEVANT, WI

* BEING ACQUIRED.

KVNA ACQUISITION, LLC IS THE LICENSEE OF THE STATION LISTED BELOW:

KZLB(FM), ID #68566, FLAGSTAFF, AZ




Attachment 3
Description
Exhibit 3 - Attachment 1 Organizational Diagram