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-20111209IUC
Section I - General Information
1. Legal Name of the Respondent
MADISON DEARBORN PARTNERS V-A&C, 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. , NEW JERSEY Television
9. , PENNSYLVANIA Class A TV
10. , TEXAS Television
11. , FLORIDA Television
12. , FLORIDA Television
13. , OHIO Television
14. , COLORADO Television
15. , CALIFORNIA Television
16. , CALIFORNIA Television
17. , ARIZONA Class A TV
18. , TEXAS Television
19. , CALIFORNIA Television
20. , CALIFORNIA Class A TV
21. , CALIFORNIA Class A TV
22. , CALIFORNIA TV Translator or LPTV station
23. , PUERTO RICO Television
24. , PUERTO RICO Television
25. , PUERTO RICO Television
26. , NEW YORK FM Station
27. , NEW YORK AM Station
28. , CALIFORNIA FM Station
29. , CALIFORNIA AM Station
30. , CALIFORNIA FM Station
31. , CALIFORNIA FM Station
32. , CALIFORNIA FM Station
33. , ILLINOIS AM Station
34. , TEXAS FM Station
35. , TEXAS FM Station
36. , TEXAS FM Station
37. , TEXAS FM Station
38. , TEXAS AM Station
39. , TEXAS FM Station
40. , CALIFORNIA FM Station
41. , CALIFORNIA FM Station
42. , CALIFORNIA FM Station
43. , NEW MEXICO FM Station
44. , TEXAS AM Station
45. , TEXAS FM Station
46. , TEXAS FM Station
47. , NEVADA AM Station
48. , NEVADA FM Station
49. , NEVADA FM Station
50. , TEXAS FM Station
51. , TEXAS FM Station
52. , NEW MEXICO FM Station
53. , NEW MEXICO FM Station
54. , NEW MEXICO FM Station
55. , TEXAS AM Station
56. , TEXAS FM Station
57. , TEXAS AM Station
58. , ILLINOIS Television
59. , CALIFORNIA Class A TV
60. , TEXAS Television
61. , TEXAS Television
62. , CALIFORNIA Television
63. , CALIFORNIA Television
64. , MASSACHUSETTS Television
65. , GEORGIA Television
66. , VIRGINIA Television
67. , TEXAS Television
68. , TEXAS Television
69. , ARIZONA Television
70. , ARIZONA Television
71. , ARIZONA Class A TV
72. , ARIZONA Class A TV
73. , ARIZONA TV Translator or LPTV station
74. , ARIZONA TV Translator or LPTV station
75. , FLORIDA Television
76. , CALIFORNIA Television
77. , CALIFORNIA Class A TV
78. , NORTH CAROLINA Television
79. , CALIFORNIA Television
80. , CALIFORNIA Television
81. , CALIFORNIA Class A TV
82. , CALIFORNIA Class A TV
83. , NORTH CAROLINA Television
84. , NORTH CAROLINA TV Translator or LPTV station
85. , UTAH Television
86. , TEXAS Television
87. , TEXAS Class A TV
88. , TEXAS Television
89. , TEXAS Class A TV
90. , NEW MEXICO Television
91. , TEXAS Class A TV
92. , CALIFORNIA Television
93. , CALIFORNIA Television
94. , CALIFORNIA TV Translator or LPTV station
95. , ARIZONA Television
96. , ARIZONA Television
97. , ARIZONA Class A TV
98. , ILLINOIS FM Station
99. , ILLINOIS FM Station
100. , IOWA FM Station
101. , ILLINOIS FM Station
102. , CALIFORNIA FM Station
103. , CALIFORNIA FM Station
104. , CALIFORNIA FM Station
105. , CALIFORNIA FM Station
106. , CALIFORNIA FM Station
107. , CALIFORNIA AM Station
108. , TEXAS FM Station
109. , TEXAS AM Station
110. , TEXAS FM Station
111. , TEXAS FM Station
112. , TEXAS AM Station
113. , TEXAS FM Station
114. , TEXAS FM Station
115. , TEXAS FM Station
116. , TEXAS FM Station
117. , FLORIDA FM Station
118. , FLORIDA FM Station
119. , FLORIDA AM Station
120. , FLORIDA AM Station
121. , PUERTO RICO AM Station
122. , PUERTO RICO FM Station
123. , PUERTO RICO AM Station
124. , PUERTO RICO FM Station
125. , PUERTO RICO AM Station
126. , ARIZONA FM Station
127. , ARIZONA FM Station
128. , ARIZONA FM Station
129. , ARIZONA FM Station
130. , ARIZONA FM Station
131. , CALIFORNIA FM Station
132. , CALIFORNIA FM Station
133. , TEXAS FM Station
134. , TEXAS FM Station
135. , TEXAS 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
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)		 %  
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
0020094249
  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 DEARBORN PARTNERS, LLC, THE GP

(Official Title)


of RESPONDENT MADISON DEARBORN PARTNERS V-A&C, 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 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