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.

BOA - 20150720ABH
Section I - General
1. Legal Name of the Licensee/Permittee
HUMBOLDT STATE UNIVERSITY ADVANCEMENT FOUNDATION
Mailing Address
NELSON HALL WEST, ROOM 208
1 HARPST STREET
City
ARCATA
State or Country (if foreign address)
CA
ZIP Code
95521 -
Telephone Number (include area code)
7078265146
E-Mail Address (if available) 
FCC Registration Number:
0019598291
Call Sign 
KHSM
Facility ID Number 
184514
2. Contact Representative (if other than Licensee/Permittee)
MARGARET L. MILLER
Firm or Company Name
GRAY MILLER PERSH LLP
Mailing Address
1200 NEW HAMPSHIRE AVE., NW
City
WASHINGTON
State or Country (if foreign address)
DC
ZIP Code
20036 -
Telephone Number (include area code)
2027762914
E-Mail Address (if available)
MMILLER@GRAYMILLERPERSH.COM
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 06/09/2015 (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
KHSM 184514 MCKINLEYVILLE CA 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]


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 (mm/dd/yyyy) Date of Expiration (mm/dd/yyyy)
RESTATED ARTICLES OF INCORPORATION ENTITY 10/19/2012

Description of Contract or Instrument Name of person or organization with whom contract is made Date of Execution (mm/dd/yyyy) Date of Expiration (mm/dd/yyyy)
BYLAWS (AMENDED) ENTITY 03/18/2011


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. HEATHER BERNIKOFF-RABOY, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

CHAIR

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PROGRAM OFFICER, CALIFORNIA CONSUMER PROTECTION

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. ALISA JUDGE, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

VICE CHAIR

d. Percent of interest held.

0.00

e. Principal profession or occupation.

SVP HUMAN RESOURCES, EVANS ANALYTICAL GROUP

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. JOYCE LOPES, HSU, 1 HARPST ST., ARCATA, CA 95521
b. Citizenship. US

c. Office held.

SECRETARY

d. Percent of interest held.

0.00

e. Principal profession or occupation.

VICE PRESIDENT, HUMBOLDT STATE UNIVERSITY

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. JASON RAMOS, HSU, 1 HARPST ST, NHW 208, ARCATA, CA
b. Citizenship. US

c. Office held.

TREASURER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

GAMING COMMISSIONER CHAIRMAN, BLUE LAKE CASINO

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

ON THE BOARD OF LOST COAST COMMUNICATIONS, INC., LICENSEE OF RADIO STATIONS KHUM(FM), KSLG-FM, AND KXGO(FM).

a. Name and Address. GUY ARONOFF, HSU, 1 HARPST ST, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

LECTURER, HUMBOLDT STATE UNIVERSITY

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. PEG BLAKE, HSU, 1 HARPST ST, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

VICE PRESIDENT, HUMBOLDT STATE UNIVERSITY

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. GARY BLATNICK, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. STEVEN R. BROWN, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

CHAIRMAN OF THE BOARD, NEXGEN PHARMA

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. KEN DAVLIN, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT, OSCAR LARSON & ASSOCIATES

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. JUDY DVORAK, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. LAURA FISHER, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ENVIRON HEALTH AND SAFETY SPECIALIST, SMUD

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. NICK FRANK, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESS CONSULTANT

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. DAN JOHNSON, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

CEO, THE DANCO GROUP

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. DAVID KALB, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT, RIVERVIEW CONSULTING, INC.

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. LISA KLYCE, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

NONE

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. ALISTAIR MCCRONE, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT EMERITUS, HSU

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. HEIDI MOORE-GUYNUP, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

CURRICULUM & INSTRUC COORD, HUM CO OFF OF EDUC

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. CHUCK PETRUSHA, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT/CEO ADVANCED SECURITY SYSTEMS

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. DUNCAN ROBINS, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. CN

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

CONSULTANT

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. LISA ROSSBACHER, HSU, 1 HARPST ST, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT, HUMBOLDT STATE UNIVERSITY

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. GARY RYNEARSON, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

MGR, FOREST POLICY/SUSTAINABILITY, GREEN DIAMOND

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. GEORGE SCHMIDBAUER, HSU, 1 HARPST ST, NHW 208, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PRESIDENT/CEO, SCHMIDBAUER LUMBER, INC.

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. CRAIG WRUCK, HSU, 1 HARPST ST, ARCATA, CA 95521
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

HSU VICE PRES, UNIVERSITY ADVANCEMENT, HSUAF EXECUTIVE DIREC

f. By whom appointed or elected.

HSU PRESIDENT

g. Existing interests

NONE

a. Name and Address. HUMBOLDT STATE UNIVERSITY ADVANCEMENT FOUNDATION, 1 HARPST ST., NELSON HALL WEST 208, ARCATA, CA 95521
b. Citizenship. NA

c. Office held.

ENTITY

d. Percent of interest held.

100.00

e. Principal profession or occupation.

N/A

f. By whom appointed or elected.

N/A

g. Existing interests

BOARD MEMBERS OF THE HUMBOLDT STATE UNIVERSITY ADVANCEMENT FOUNDATION INCLUDE OFFICERS OF HUMBOLDT STATE UNIVERSITY, LICENSEE OF NONCOMMERCIAL FM STATIONS KHSF, KHSG, KHSU, AND KHSR, AND LPFM STATION KRFH-LP.




SECTION III - CERTIFICATION


I certify that I am EXECUTIVE DIRECTOR

(Official Title)


of HUMBOLDT STATE UNIVERSITY ADVANCEMENT FOUNDATION

(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
CRAIG C. WRUCK
Date
07/17/2015
Telephone Number of Respondent (Include area code) 7078265101


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