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 |
NORWEST EQUITY PARTNERS VI, LP, 3600 IDS CENTER, 80 SOUTH 8TH STREET, MINNEAPOLIS, MN 55402 |
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 |
MEMBER |
7. Percentage of votes |
58.10 |
8. Percentage of total assets (equity debt plus) |
22.00 |
1. Name and Address |
NORWEST EQUITY PARTNERS VII, LP, 3600 IDS CENTER, 80 SOUTH 8TH STREET, MINNEAPOLIS, MN 55402 |
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 |
MEMBER |
7. Percentage of votes |
24.10 |
8. Percentage of total assets (equity debt plus) |
9.10 |
1. Name and Address |
JUDYTH V. PETERSON AND NORMAN C. PETERSON AS CO-TRUSTEES OF THE PETERSON FAMILY TRUST, 23 CARIBOU COURT, MONTEREY, CA 93940 |
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 |
MEMBER |
7. Percentage of votes |
1.00 |
8. Percentage of total assets (equity debt plus) |
0.40 |
1. Name and Address |
GEORGE W. COUCH III, TRUSTEE OF THE GEORGE W. COUCH III REVOCABLE TRUST, 1502 VISCAINO ROAD, PEBBLE BEACH, CA 93953 |
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 |
MEMBER |
7. Percentage of votes |
8.20 |
8. Percentage of total assets (equity debt plus) |
3.10 |
1. Name and Address |
DAVID J. BENJAMIN AND LAURIE M. PETERSON, TRUSTEES OF THE BENJAMIN TRUST, 8 LOS ROBLES, CARMEL VALLEY, CA 93924 |
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 |
MEMBER |
7. Percentage of votes |
3.60 |
8. Percentage of total assets (equity debt plus) |
1.40 |
1. Name and Address |
THOMAS S. DOUGLAS, 62 MORNINGSIDE DRIVE SOUTH, WESTPORT, CT 06880 |
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 |
MEMBER, SENIOR VP, CFO, TREASURER |
7. Percentage of votes |
2.10 |
8. Percentage of total assets (equity debt plus) |
0.80 |
1. Name and Address |
CECELIA GREEN, 3924 RIDGEMOOR DRIVE, RAPID CITY, SD 57702 |
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 |
MEMBER, VICE PRESIDENT |
7. Percentage of votes |
0.80 |
8. Percentage of total assets (equity debt plus) |
0.30 |
1. Name and Address |
NANCY ODNEY, 642 HARWOOD DRIVE, FARGO, ND 58104 |
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 |
MEMBER, VICE PRESIDENT |
7. Percentage of votes |
0.30 |
8. Percentage of total assets (equity debt plus) |
0.10 |
1. Name and Address |
STEPHEN FEHDER AND KATHLEEN FEHDER AS JOINT TENANTS WITH RIGHT OF SURVIVORSHIP, 1642 SPRING DRIVE, LOUISVILLE, KY 40205 |
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 |
MEMBER, SENIOR VICE PRESIDENT |
7. Percentage of votes |
0.90 |
8. Percentage of total assets (equity debt plus) |
0.30 |
1. Name and Address |
MAURICE BURCH AND LILLIAN BURCH AS JOINT TENANTS WITH RIGHT OF SURVIVORSHIP, 32380 BAYOU PAQUET, SLIDELL, LA 70460 |
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 |
MEMBER, VICE PRESIDENT |
7. Percentage of votes |
0.30 |
8. Percentage of total assets (equity debt plus) |
0.10 |
1. Name and Address |
DAVID J. BENJAMIN, III, 8 LOS ROBLES, CARMEL VALLEY, CA 93924 |
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 |
GOVERNOR, PRESIDENT, CEO |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JUDYTH V. PETERSON, 23 CARIBOU COURT, MONETERY, CA 93940 |
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, VICE PRESIDENT |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
GEORGE W. COUCH, 1502 VISCAINO ROAD, PEBBLE BEACH, CA 93953 |
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 |
GOVERNOR |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JOHN E. LINDAHL, 3222 ROBINSON'S BAY ROAD, DEEP HAVEN, MN 55391 |
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 |
GOVERNOR |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
STEVEN BURGE, 333 SOUTH GRAND AVE., SUITE 1150, LOS ANGELES, CA 90071 |
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 |
GOVERNOR |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
STEPHEN FEHDER, 1642 SPRING DRIVE, LOUISVILLE, KY 40205 |
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 |
SENIOR VICE PRESIDENT |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.40 |
1. Name and Address |
MIKE WILD, 11330 NORTH ANTLER PLACE, PEORIA, IL 61615 |
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 |
MEMBER, VICE PRESIDENT |
7. Percentage of votes |
0.60 |
8. Percentage of total assets (equity debt plus) |
0.20 |
1. Name and Address |
JUNE PONG, 17564 CROSS ROAD, SALINAS, CA 93907 |
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 |
VICE PRESIDENT |
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]
|
|