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1. | Legal Name of the Licensee/Permittee KSER FOUNDATION |
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Mailing Address 14920 HIGHWAY 99, SUITE 150 |
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City LYNNWOOD |
State or Country (if foreign address) WA |
ZIP Code 98037 - |
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Telephone Number (include area code) 4257424541 |
E-Mail Address (if available) KSER@AOL.COM |
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FCC Registration Number: |
Call Sign KSER |
Facility ID Number 29649 |
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2. | Contact Representative (if other than Licensee/Permittee) |
Firm or Company Name |
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Mailing Address |
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City |
State or Country (if foreign address) |
ZIP Code - |
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Telephone Number (include area code) |
E-Mail Address (if available) NA |
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3. | Name of entity, if other than licensee or permittee, for which report is filed |
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Mailing Address |
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City |
State or Country (if foreign address) |
ZIP Code - |
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Telephone Number (include area code) |
E-Mail Address (if available) NA |
Section II - Ownership Information
4. |
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5. |
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6. |
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7. |
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SECTION III - CERTIFICATION
I certify that I am JOHN THIELKE (PRESIDENT)
(Official Title)
of KSER 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 KSER FOUNDATION |
Date 09/11/2001 |
Telephone Number of Respondent (Include area code) 2065423641 |
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).