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.

690667 -
Section I - General Information
1. Legal Name of the Applicant 

Mailing Address

City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
E-Mail Address (if available) 
FCC Registration Number:

Call Sign 
Facility ID Number 
49320
2. Contact Representative (if other than Licensee/Permittee)

Firm or Company Name

Telephone Number (include area code)

E-Mail Address (if available)

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
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
08/04/2003


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service


Call Letters
Facility ID Number
Location (City/State)
Class of service



All of the information furnished in this Report is accurate as of (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
Y

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration


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
32966

RESTATED CERTIFICATE OF INCORPORATION OF ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32967

ARTICLES OF INCORPORATION, AS AMENDED, OF CAPITAL CITIES COMMUNICATIONS, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32968

CERTIFICATE OF AMENDMENT OF CERTIFICATE OF INCORPORATION OF CAPITAL CITIES COMMUNICATIONS, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32969

RESTATED CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32970

CERTIFICATE OF AMENDMENT OF THE CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32971

CERTIFICATE OF CHANGE OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32972

CERTIFICATE OF CHANGE OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32973

CERTIFICATE OF AMENDMENT OF CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32974

RESTATED CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32975

CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32976

BY-LAWS OF CAPITAL CITIES/ABC, INC., RESTATED AS OF APRIL 19, 1995 AND THEREAFTER AS AMENDED THROUGH SEPTEMBER 18, 1990

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32977

BY-LAWS OF CAPITAL CITIES/ABC, INC.

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32978

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WPVI-TV, RENEWED EFFECTIVE AUGUST 15, 1989. AMENDED EFFECTIVE AUGUST 21, 1989 TO PROVIDE NETWORK NON-DUPLICATION PROTECTION.
WPVI-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32979

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WPVI-TV, DATED DECEMBER 21, 1990, EFFECTIVE AUGUST 15, 1991; AUTOMATICALLY RENEWABLE FOR SUCCESSIVE TWO-YEAR TERMS. THIS CONTRACT SUPERSEDES CONTRACT NUMBER 13 ABOVE.
WPVI-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32980

MODIFICATION DATED SEPTEMBER 20, 1991, EFFECTIVE JANUARY 6, 1992, REPLACING SCHEDULE A CONTAINED IN NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WPVI-TV, SET FORTH IN CONTRACT NUMBER 13 ABOVE.
WPVI-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32981

NOTICE OF NETWORK STATION RATE ADJUSTMENT DATED APRIL 13, 1992, PURSUANT TO SCHEDULE A OF NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WPVI-TV, SET FORTH IN CONTRACT NUMBER 13 ABOVE.
WPVI-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32982

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WPVI-TV DATED APRIL 15, 1993, EFFECTIVE JULY 2, 1993 FOR A TERM OF TWO YEARS; SUPERSEDES CONTRACT NUMBER 13 ABOVE.
WPVI-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32983

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WTVD(TV), RENEWED EFFECTIVE AUGUST 4, 1989.
WTVD(TV)

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32984

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC., AND WTVD(TV), DATED DECEMBER 21, 1990, EFFECTIVE AUGUST 4, 1991; AUTOMATICALLY RENEWABLE FOR SUCCESSIVE TWO-YEAR TERMS. THSI CONTRACT SUPERSEDES CONTRACT 17 ABOVE.
WTVD(TV)

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32985

MODIFICATION DATED SEPTEMBER 20, 1991, EFFECTIVE JANUARY 6, 1992, REPLACING SCHEDULE A CONTAINED IN NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC., AND WTVD(TV), SET FORTH IN CONTRACT NUMBER 18 ABOVE.
WTVD(TV)

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32986

NOTICE OF NETWORK STATION RATE ADJUSTMENT DATED APRIL 13, 1992, EFFECTIVE JUNE 1, 1992, PURSUANT TO SCHEDULE A OF NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WTVD(TV), SET FORTH IN CONTRACT NUMBER 18 ABOVE.
WTVD(TV)

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32987

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND WTVD(TV), DATED APRIL 15, 1993, EFFECTIVE JULY 2, 1993 FOR A TERM OF TWO YEARS; AUTOMATICALLY RENEWABLE FOR SUCCESSIVE TWO-YEAR TERMS. SUPERSEDES CONTRACT 18 ABOVE.
WTVD(TV)

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32988

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND KFSN-TV, RENEWED EFFECTIVE SEPTEMBER 9, 1987; RENEWED FOR TWO-YEAR TERM EFFECTIVE SEPTEMBER 9, 1989. AMENDED AUGUST 21, 1989 TO PROVIDE NETWORK NON-DUPLICATION PROTECTION.
KFSN-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32989

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND KSFN-TV, DATED DECEMBER 21, 1990, EFFECTIVE SEPTEMBER 9, 1991; AUTOMATICALLY RENEWABLE FOR SUCCESSIVE TWO-YEAR TERMS. THIS CONTRACT SUPERSEDES CONTRACT NUMBER 22 ABOVE.
KFSN-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32990

MODIFICATION DATED SEPTEMBER 1991, EFFECTIVE JANUARY 6, 1992, RPLACING SCHEDULE A CONTAINED IN NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND KFSN-TV, SET FORTH IN CONTRACT NUMBER 23 ABOVE.
KFSN-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32991

NOTICE OF NETWORK STATION RATE ADJUSTMENT DATED APRIL 13, 1992, EFFECTIVE JUNE 1, 1992, PURSUANT TO SCHEDULE A OF NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND KFSN-TV, SET FORTH IN CONTRACT NUMBER 23.
KFSN-TV

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32992

NETWORK AFFILIATION AGREEMENT, BETWEEN AMERICAN BROADCASTING COMPANIES, INC. AND KFSN-TV, DATED APRIL 15, 1993, EFFECTIVE JULY 2, 1993 FOR A TERM OF TWO YEARS; AUTOMATICALLY RENEWABLE FOR SUCCESSIVE TWO-YEAR TERMS. SUPERSEDES CONTRACT NUMBER 23.
KFSN

Class of stock (preferred, common or other)
Voting or Non-voting
Number of Shares
Authorized
Issued and Outstanding
Treasury
Unissued
32993

CERTIFICATE OF AMENDMENT TO THE CERTIFICATE OF INCORPORATION OF CAPITAL CITIES/ABC, INC. (CHANGING NAME TO 'ABC, INC.') DATED SEPTEMBER 18, 1996.


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
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 690667
6. Positional Interest 14058
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)

1. Name and Address
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
6. Positional Interest
7. Percentage of votes
8. Percentage of total assets (equity debt plus)


(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 1000

(Official Title)


of 100

(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
Date
0
Telephone Number of Respondent (Include area code) 900

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