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 - 20020219ABU
Section I - General
1. Legal Name of the Licensee/Permittee
MODESTO ADVETIST ACADEMY
Mailing Address
2020 ACADEMY PLACE
CERES
City
CERES
State or Country (if foreign address)
CA
ZIP Code
95307 -
Telephone Number (include area code)
2095344521
E-Mail Address (if available) 
KADV@INREACH.COM
FCC Registration Number:

Call Sign 
KADV
Facility ID Number 
43333
2. Contact Representative (if other than Licensee/Permittee)
JOHN VIXIE
Firm or Company Name
MODESTO ADVENTIST ACADEMY
Mailing Address

City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
2095374521
E-Mail Address (if available)
VIXIE@THE VISION.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)
NA



Section II - Ownership Information

4.
All of the information furnished in this Report is accurate as of 10/01/2001 (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
KADV 43333 CERES 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)
NO CONTRACTS


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. FRED MANTZ, 1207 PARKS ROAD, HUGHSON, CA 95326
b. Citizenship. US

c. Office held.

PRESIDENT

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ORAL SURGEON

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. BRAD BENSON, 2400 KONA LANE CERES, CA 95307
b. Citizenship. US

c. Office held.

VICE-PRESIDENT

d. Percent of interest held.

0.00

e. Principal profession or occupation.

DEVELOPMENT DIRECTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. LARRY BENNETT,5927 WESTMINSTER COURT, RIVERBANK, CA 95367
b. Citizenship. US

c. Office held.

V.P. FINANCE

d. Percent of interest held.

0.00

e. Principal profession or occupation.

COMPUTER SPECIALIST

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. RICK CASEBIER, 905 CEDAR RIDGE ROAD, TULOCK,CA 95382
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. JAMES CHASE, 720 DORCHESTER AVENUE, MODESTO, CA 95355
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. SHIRLEY CHIBURIS, 1817 STONUM ROAD, MODESTO,CA 95351
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

HOMEMAKER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. SHIRLEY ELLIS, 1017 COPPERLAKE, MODESTO, CA 95355
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

OFFICE MANAGER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. DAVID FULLER, 1194 PARKS ROAD, HUGHSON,CA 95326
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PHYSICIAN

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. NORMAN HERMAN, 1311 COFFEE ROAD, MODESTO, 95355
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ELECTRICAL CONTRACTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. DARIN LEMOS, 2900 TIM BELL ROAD, WATERFORD, CA 95386
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

DIARYMAN

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. CLARK MCCALL, 290 WALNUT STREET, OAKDALE,CA 95361
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. LARRY MEAGER, 1309 RIVER VALLEY CIRCLE, MODESTO, CA 95351
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. KEITH MULLIGAN, 1015 MUNCHKIN DRIVE, MODESTO, CA 95351
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. HEARLY ROSCHER, 1904 INNSBROOK DRIVE, MODESTO, CA 95351
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE`

a. Name and Address. JODI SMITH, 2454 TOPEKA AVENUE, RIVERBANK,CA 95367
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ENGINEER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. PAUL SCHOOLEY, 1808 WYLIE, MODESTO, CA 95354
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

PASTOR

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. JOAN TONGE, 1813A EDGEBROOK DRIVE, MODESTO, CA 95354
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

HOMEMAKER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. BILL TYM, 5843 S. SPERRY ROAD, DENAIR, CA 95316
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.

BOARD

g. Existing interests

NONE

a. Name and Address. BERT VAN TASSELL, 171 PRISCILLA LANE, WATERFORD, CA 95386
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ACCOUNTANT

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. RODNEY DIEDE, 2035 ACADEMY PLACE, CERES,CA 95307
b. Citizenship. US

c. Office held.

EX-OFFICIO BD. MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESS MANAGER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. JOHN VIXIE, 2832 WOODMONT CIRCLE, MODESTO, A 95355
b. Citizenship. US

c. Office held.

EX-OFFICIO BD. MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

SCHOOL PRINCIPAL

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE

a. Name and Address. GAYLORD BOYER, 3124 MASON WAY, MODESTO CA95355
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.

BOARD

g. Existing interests

NONE

a. Name and Address. KENNETH UTT, 2540 FRANKS COURT, TURLOCK, CA 95380
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

SCHOOL VICE-PRINCIPAL/TEACHER

f. By whom appointed or elected.

BOARD

g. Existing interests

NONE




SECTION III - CERTIFICATION


I certify that I am PRINCIPAL/CEO

(Official Title)


of MODESTO ADVENTIST ACADEMY

(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
MODESTO ADVENTIST ACADEMY
Date
01/22/2002
Telephone Number of Respondent (Include area code) 2095374521


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