Federal Communications Commission
Washington, D.C. 20554
Approved by OMB
3060-0010 (June 2014)
FOR FCC USE ONLY
 

FCC 323
OWNERSHIP REPORT FOR COMMERCIAL BROADCAST STATIONS

FOR COMMISSION USE ONLY
FILE NO. BOA-20111209HZI

Section I - General Information
1. Legal Name of the Respondent
MADISON DEARBORN CAPITAL PARTNERS V-A, L.P.
Street Address (1)
70 W. MADISON STREET
Street Address (2)
SUITE 4600
City
CHICAGO
State or Country (if foreign address)
IL

ZIP Code
60602 -

Telephone Number (include area code)
3128951000
E-Mail Address (if available) 
FCC Registration Number:
0005794177
Call Sign 
KUVN-DT
Facility ID Number 
35841
2. Contact Representative
MACE J. ROSENSTEIN, ESQ.
Firm or Company Name
COVINGTON & BURLING LLP
Street Address (1)
1201 PENNSYLVANIA AVENUE, NW
Street Address (2)
City
WASHINGTON
State or Country (if foreign address)
DC
ZIP Code
20004 -
Telephone Number (include area code)
2026625460
E-Mail Address (if available)
MROSENSTEIN@COV.COM
3. Nature of Respondent (See Instructions for definitions)
radio button not selected Licensee
radio button not selected Permittee
radio button selected Entity with an attributable interest
4. If this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114):
radio button not selectedGovernmental Entity radio button selected radio button not selectedOther Other radio button not selected N/A (Fee Required)
5. All of the information furnished in this Report is accurate as of 10/01/2011
(Date entered must (1) be Oct. 1 of the filing year when filing a Biennial Ownership Report (or Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)
6. Purpose: This Report is filed for: (choose one)
a. radio button selected Biennial
b. radio button not selected Validation and Resubmission of a previously filed Biennial Report (certifying no change from previous Report)
c. radio button not selected Transfer of Control or Assignment of License/Permit
d. radio button not selected Report by Permittee filing within 30 days after the grant of a construction permit for a new commercial AM, FM or full power television broadcast station.
e. radio button not selected Update / certification of accuracy of an initial Ownership Report filed by Permittee (filing in conjunction with Permittee's application for a station license)
f. radio button not selected Amendment to a previously filed Ownership Report
File Number: -
If an Amendment, submit as an Exhibit a listing by Section and Question Number the portions of the previous Report that are being revised.
7. Licensee and Station Information. The stations listed below are all licensed to the following person or entity:
Licensee Name Licensee's FCC Registration Number (FRN)
UNIVISION COMMUNICATIONS, INC.
0005794177
FRN Help: CORES Home

Station List

This Report is filed for the following stations:
Copy Call Sign Facility ID Number Location (City/State) Class of service Delete Copy
1. , NEW YORK Television
2. , NEW JERSEY Television
3. , NEW JERSEY Television
4. , CALIFORNIA Television
5. , CALIFORNIA Television
6. , ILLINOIS Television
7. , IOWA Television
8. , MASSACHUSETTS Television
9. , GEORGIA Television
10. , VIRGINIA Television
11. , TEXAS Television
12. , TEXAS Television
13. , ARIZONA Television
14. , ARIZONA Television
15. , ARIZONA Class A TV
16. , ARIZONA Class A TV
17. , ARIZONA TV Translator or LPTV station
18. , ARIZONA TV Translator or LPTV station
19. , TEXAS Television
20. , TEXAS Class A TV
21. , TEXAS Television
22. , TEXAS Class A TV
23. , NEW MEXICO Television
24. , TEXAS Class A TV
25. , CALIFORNIA Television
26. , CALIFORNIA Television
27. , ILLINOIS AM Station
28. , ILLINOIS FM Station
29. , PUERTO RICO FM Station
30. , PUERTO RICO AM Station
31. , ARIZONA FM Station
32. , NEW MEXICO FM Station
33. , NEW MEXICO FM Station
34. , TEXAS AM Station
35. , TEXAS FM Station
36. , TEXAS AM Station
37. , ILLINOIS Television
38. , CALIFORNIA Class A TV
39. , NEW JERSEY Television
40. , PENNSYLVANIA Class A TV
41. , TEXAS Television
42. , TEXAS Television
43. , TEXAS Television
44. , CALIFORNIA Television
45. , CALIFORNIA Television
46. , FLORIDA Television
47. , FLORIDA Television
48. , FLORIDA Television
49. , OHIO Television
50. , COLORADO Television
51. , CALIFORNIA Television
52. , CALIFORNIA Television
53. , CALIFORNIA Television
54. , CALIFORNIA Class A TV
55. , NORTH CAROLINA Television
56. , CALIFORNIA Television
57. , CALIFORNIA Television
58. , CALIFORNIA Class A TV
59. , CALIFORNIA Class A TV
60. , NORTH CAROLINA Television
61. , NORTH CAROLINA TV Translator or LPTV station
62. , UTAH Television
63. , CALIFORNIA TV Translator or LPTV station
64. , ARIZONA Television
65. , ARIZONA Television
66. , ARIZONA Class A TV
67. , ARIZONA Class A TV
68. , TEXAS Television
69. , CALIFORNIA Television
70. , CALIFORNIA Class A TV
71. , CALIFORNIA Class A TV
72. , CALIFORNIA TV Translator or LPTV station
73. , PUERTO RICO Television
74. , PUERTO RICO Television
75. , PUERTO RICO Television
76. , NEW YORK FM Station
77. , NEW YORK AM Station
78. , CALIFORNIA FM Station
79. , CALIFORNIA AM Station
80. , CALIFORNIA FM Station
81. , CALIFORNIA FM Station
82. , CALIFORNIA FM Station
83. , ILLINOIS FM Station
84. , IOWA FM Station
85. , ILLINOIS FM Station
86. , CALIFORNIA FM Station
87. , CALIFORNIA FM Station
88. , CALIFORNIA FM Station
89. , CALIFORNIA FM Station
90. , CALIFORNIA FM Station
91. , CALIFORNIA AM Station
92. , TEXAS FM Station
93. , TEXAS FM Station
94. , TEXAS FM Station
95. , TEXAS AM Station
96. , TEXAS FM Station
97. , TEXAS FM Station
98. , TEXAS AM Station
99. , TEXAS FM Station
100. , TEXAS FM Station
101. , TEXAS FM Station
102. , TEXAS FM Station
103. , FLORIDA FM Station
104. , FLORIDA FM Station
105. , FLORIDA AM Station
106. , FLORIDA AM Station
107. , PUERTO RICO AM Station
108. , PUERTO RICO FM Station
109. , PUERTO RICO AM Station
110. , ARIZONA FM Station
111. , ARIZONA FM Station
112. , ARIZONA FM Station
113. , ARIZONA FM Station
114. , CALIFORNIA FM Station
115. , CALIFORNIA FM Station
116. , TEXAS FM Station
117. , TEXAS FM Station
118. , TEXAS FM Station
119. , TEXAS FM Station
120. , TEXAS FM Station
121. , TEXAS AM Station
122. , TEXAS FM Station
123. , CALIFORNIA FM Station
124. , CALIFORNIA FM Station
125. , CALIFORNIA FM Station
126. , NEW MEXICO FM Station
127. , TEXAS AM Station
128. , TEXAS FM Station
129. , TEXAS FM Station
130. , NEVADA AM Station
131. , NEVADA FM Station
132. , NEVADA FM Station
133. , TEXAS FM Station
134. , TEXAS FM Station
135. , NEW MEXICO FM Station

(Check/Uncheck All)
 
8. Respondent is:
radio button not selected Sole Proprietorship radio button not selected Not-for-profit corporation radio button selected Limited partnership
radio button not selected For-profit corporation radio button not selected General partnership radio button not selected Other
If "Other," describe nature of the Respondent in an Exhibit.  
 
 

Section II-B - Biennial Ownership Information

1. Contract Information. List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613. (Only Licensees, or Respondents with a majority interest in or that otherwise exercise de facto control over the subject Licensee shall respond. Other Respondents should select "Not Applicable" in response to this question.) If the agreement is a local marketing agreement (LMA) or a joint sales agreement (JSA), or if the agreement is a network affiliation agreement, check the appropriate box; otherwise, select "Other" for non-LMA/JSA or network affiliation agreements.
checkbox checked Not Applicable

Contract Information

   



2. Capitalization (Only Licensees or entities with a majority interest in or that otherwise exercises de facto control over the subject Licensee shall respond.)
checkbox checked Not Applicable

Capitalization Information


(Check/
Uncheck All)
 
3. (a.) Ownership Interests. This Question requires Respondents to enter detailed information about ownership interests by generating a series of subforms. Answer each question on each subform. The first subform listing should be for the Respondent itself. If the Respondent is not a natural person, also list each of the officers, directors, stockholders, noninsulated partners, members and other persons or entities with a direct attributable interest in the Respondent. (A "direct" interest is one that is not held through any intervening companies or entities.) In the case of vertical or indirect ownership structures, report only those interests in the Respondent that also represent an attributable interest in the Licensee for which the Report is being submitted.

List each person or entity with a direct attributable interest in the Respondent separately. Entities that are part of an organizational structure that includes holding companies or other forms of indirect ownership must file separate ownership reports. In such a structure do not report or file separate reports for persons or entities that do not have an attributable interest in the Licensee for which the report is being submitted.

Ownership Interests Information

Copy 1. Name  
Address Street


City/State
, ILLINOIS
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button selected Respondent
radio button not selected Other Interest Holder
Relationship to Licensee radio button not selected Licensee (or Officer/Director of Licensee)
radio button not selected Person with attributable interest
radio button selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox not checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
0020092748
  Gender, Ethnicity, Race and Citizenship Information
(Natural Persons)
checkbox checked N/A (entity)  
Gender
radio button not selected Male radio button not selected Female
Ethnicity
radio button not selected Hispanic or Latino
radio button not selected Not Hispanic or Latino
Race (Check all that apply)
checkbox not checked American Indian or Alaska Native
checkbox not checked Asian
checkbox not checked Black or African American
checkbox not checked Native Hawaiian or Other Pacific Islander
checkbox not checked White
Citizenship
  Percentage of votes %  
  Percentage of equity %  
  Percentage of total assets
(equity debt plus)
%  
Copy 2. Name  
Address Street


City/State
, ILLINOIS
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee radio button not selected Licensee (or Officer/Director of Licensee)
radio button not selected Person with attributable interest
radio button selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox not checked Director
checkbox checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
0020092706
  Gender, Ethnicity, Race and Citizenship Information
(Natural Persons)
checkbox checked N/A (entity)  
Gender
radio button not selected Male radio button not selected Female
Ethnicity
radio button not selected Hispanic or Latino
radio button not selected Not Hispanic or Latino
Race (Check all that apply)
checkbox not checked American Indian or Alaska Native
checkbox not checked Asian
checkbox not checked Black or African American
checkbox not checked Native Hawaiian or Other Pacific Islander
checkbox not checked White
Citizenship
  Percentage of votes %  
  Percentage of equity %  
  Percentage of total assets
(equity debt plus)
%  

(Check/
Uncheck All)

  (b.)

Respondent certifies that any equity and financial interests not reported in response to Question 3(a) are non-attributable.


If "No," submit as an Exhibit an explanation.

radio button selectedYes radio button not selectedNo
(c.) Does the Respondent or any person/entity with an attributable interest in the Respondent also hold an attributable interest in any other broadcast station, or in any newspaper entities in the same market, as defined in 47 C.F.R. Section 73.3555?

If "Yes", provide information describing the interest(s), using EITHER the subform OR the spreadsheet option below for the applicable type of interest (broadcast or newspaper). Respondents with a large number (50 or more) of entries to submit should use the spreadsheet option. NOTE: Spreadsheets must be submitted in a special "XML Spreadsheet" format with the appropriate structure that is specified in the documentation. For instructions on how to use the spreadsheet option to complete this question (including templates to start with), please Click Here.


Broadcast Interest Information

Newspaper Interest Information

radio button not selectedYes radio button selectedNo
(d.)

Are any of the individuals listed in response to Question 3(a) married, related as parent-child, or related as siblings?

If "Yes", complete the information describing the relationship.


Familial Relationships


(Check/Uncheck All)
 

radio button not selectedYes radio button selectedNo
(e.) Is Respondent seeking an attribution exemption for any officer or director with duties unrelated to the Licensee ?

If "Yes", complete the information in the required fields and submit an Exhibit fully describing that individual's duties and responsibilities, and explaining why that individual should not be attributed an interest.

Exemption Information List

 

(Check/
Uncheck All)

radio button not selectedYes radio button selectedNo
4.  

Respondent's Interests Held. Each Respondent other than a Licensee should list the name and FCC Registration Number of all entities in which the Respondent holds a direct attributable ownership interest, where that listed entity has an attributable ownership interest in the Licensee of the stations associated with the Report. Licensees should select "N/A" in response to this question.


For any listing that includes the name of a person or entity reported on multiple Ownership Reports, ensure that the FRN information is consistent among all such Ownership Reports. Respondents should coordinate with each other to ensure such consistency.

Respondent's Interests

Copy 1. Name
FCC Registration Number
Delete Copy
 

(Check/Uncheck All)
 

checkbox not checked N/A
5.   Organizational Chart. LICENSEES ONLY: Attach a flowchart or similar document showing the Licensee's vertical ownership structure including the Licensee and all persons/entities that have attributable interests in the Licensee.


Non-Licensee Respondents should select "N/A" in response to this question.

 

checkbox checked N/A

SECTION III - CERTIFICATION


I certify that I am CHAIRMAN OF MADISON DEABORN PARTNERS, LLC, THE GP

(Official Title)


of MADISON DEARBORN PARTNERS V-A&C, L.P., THE GP OF RESPONDENT

(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 the signature below must (1) be no earlier than Oct. 1 of the filing year when filing a Biennial Ownership Report (and no earlier than Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)

Signature
JOHN A. CANNING, JR.
Date
12/08/2011
Telephone Number of Respondent (Include area code) 3128951000

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: 
SUPPLEMENTAL RESPONSE TO SECTION II-B, QUESTION 3

THERE ARE NOT ANY PARTIES WITH AN ATTRIBUTABLE INTEREST IN THE RESPONDENT PURSUANT TO THE FCC'S "EQUITY-DEBT-PLUS" ATTRIBUTION STANDARD (AND A ZERO IS LISTED IN THE PERCENTAGE OF ASSETS COLUMN OF THIS REPORT). CERTAIN OTHER CURRENT OR FORMER PRINCIPALS AND/OR EMPLOYEES OF MADISON DEARBORN PARTNERS, L.P. (OR THEIR FAMILY MEMBERS) FROM TIME TO TIME HOLD FRACTIONAL NONVOTING EQUITY INTERESTS IN RESPONDENT. EXCEPT TO THE EXTENT OTHERWISE DISCLOSED IN THE OWNERSHIP REPORTS BEING FILED CONCURRENTLY HEREWITH ON BEHALF OF BROADCASTING MEDIA PARTNERS, INC., BROADCAST MEDIA PARTNERS HOLDINGS, INC., AND UNIVISION COMMUNICATIONS INC. (COLLECTIVELY "THE COMPANY"), NONE OF THESE INDIVIDUALS ARE INVOLVED IN THE MEDIA ACTIVITIES OF THE COMPANY.

Attachment 5
Description
Exhibit 5