Federal Communications Commission
Washington, D.C. 20554
Approved by OMB
3060-0084 (June 2002)
FCC 323-E
FOR FCC USE ONLY
 
Ownership Report For Noncommercial Educational Broadcast Station

Read INSTRUCTIONS Before Filling Out Form

FOR COMMISSION USE ONLY
FILE NO.

BON - 20090501AAA
Section I - General
1. Legal Name of the Licensee/Permittee
PORT TOWNSEND SEVENTH-DAY ADVENTIST CHURCH
Mailing Address
331 BENTON STREET
City
PORT TOWNSEND
State or Country (if foreign address)
WA
ZIP Code
98368 -
Telephone Number (include area code)
3603855774
E-Mail Address (if available) 
FCC Registration Number:
0017047663
Call Sign 
NEW
Facility ID Number 
173495
2. Contact Representative (if other than Licensee/Permittee)
DONALD MARTIN
Firm or Company Name
DONALD E. MARTIN, P.C.
Mailing Address

City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
7036422344
E-Mail Address (if available)
DEMPC@PRODIGY.NET
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)



Section II - Ownership Information

4.
All of the information furnished in this Report is accurate as of 04/22/2009 (Date must comply with 47 C.F.R. Section 73.3615(d), i.e., information must be current within 60 days of filing of this report, when 4(a) below is checked.)

This Report is filed for (check one)
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
NEW 173495 PORT TOWNSEND WA FM


5.
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]



6.
Is the governing board directly or indirectly under the control of another entity?
Yes No
If Yes, is a separate FCC Form 323-E submitted for such entity?
Yes No
 7.
List officers, members of governing board, and holders of 1% or more ownership interest, if any. Use one column for each individual or entity. Attach supplemental pages, if necessary.
[Enter Owner Information]

Owner Information
List officers, members of governing board, and holders of 1% or more ownership interest, if any. Use one column for each individual or entity. Attach supplemental pages if necessary.
(Read carefully - The numbered items below refer to line numbers in the following table.)
a. Name and address of officer, member of governing board, and holders of 1% or more ownership interest (if other than individual also show name, address and citizenship of natural person authorized to vote the interest). List officers first, then board members, and thereafter, holders of 1% or more ownership interest, if any.
b. Citizenship.
c. Office held.
d. Percent of interest held.
e. Principal profession or occupation.
f. By whom appointed or elected.
g. Existing interests in any other broadcast station, including the nature and size of such interests.
a. Name and Address. GLENN GATELY 711 ROBBINS RD., NORDLAND, WA 98358
b. Citizenship. US

c. Office held.

HEAD ELDER, BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

FISHERY BIOLOGIST

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. KIM BERG, 2965 PARADISE BAY RD., PORT LUDLOW, WA 98365
b. Citizenship. US

c. Office held.

CHAIR, BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. JIM WILSON, PO BOX 210, PORT TOWNSEND, WA 98368
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

DENTAL TECHNICIAN

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. WILLIAM MIKE RODGERS, PO BOX 593, POULSBO, WA 98370
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

PHYSICAL THERAPIST

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. HARLAN PADDOCK, POBOX 236, NORDLAND, WA 98358
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

TRUCK DRIVER

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. JULIE CHURCHLEY, 2037 HAINES ST., PORT TOWNSEND, WA 98368
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

NURSE

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. PATTI FIEDLER, 1376 EAST MARROWSTONE RD., NORDLAND, WA 98358
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

HOUSEWIFE

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. LAVONNE GRIMES, PO BOX 454, CHIMACUM, WA 98325
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

SPECIAL EDUCATION DIRECTOR

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. BONNIE-DEE HIGHFIELD, PO BOX 224, NORDLAND, WA 98358
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

LABORATORY DIRECTOR

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. DANIEL FOUNTAIN, 1306 25TH ST., PORT TOWNSEND, WA 98368
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

TEACHER

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. BERTHA ULRICH, 5325 CAPE GEORGE RD., PORT TOWNSEND, WA 98368
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

HOUSEWIFE

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE

a. Name and Address. CARL SWIGART
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

2.00

e. Principal profession or occupation.

ENGINEER

f. By whom appointed or elected.

MEMBERSHIP

g. Existing interests

NONE




SECTION III - CERTIFICATION


I certify that I am HEAD HELDER

(Official Title)


of PORT TOWNSEND SEVENTH-DAY ADVENTIST CHURCH

(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 4, Section II and in no event prior to that date.)

Signature
GLENN GATELY
Date
04/22/2009
Telephone Number of Respondent (Include area code) 3603855774


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