9. |
(a.) |
List the respondent, and, if other than a natural person, its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. If a corporation or partnership holds an attributable interest in the respondent, list separately its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. Create a separate row for each individual or entity. Attach supplemental pages, if necessary.
[Enter Owner Information]
Owner Information
List the respondent, and, if other than a natural person, its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. If a corporation or partnership holds an attributable interest in the respondent, list separately its officers, directors, stockholders and other entities with attributable interests, non-insulated partners and/or members. Create a separate row for each individual or entity. Attach supplemental pages, if necessary.
(Read carefully - The numbered items below refer to line numbers in the following table.) |
1. Name and address of respondent and each party to the respondent holding an attributable interest (if other than individual also show name, address and citizenship of natural person authorized to vote the stock or holding the attributable interest). List the respondent first, officers next, then directors and, thereafter, remaining stockholders and other entities with attributable interests, and partners.
2. Gender (male or female).
3. Ethnicity (check one).
4. Race (select one or more).
5. Citizenship. 6. Positional interest: Officer, director, general partner, limited partner, LLC member, investor/creditor attributable under the Commission's equity/debt plus standard, etc.
7. Percentage of votes.
8. Percentage of total assets (equity debt plus).
|
1. Name and Address |
MR. N. MARK EWING, 3890 EAST JOHNSON FARM ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
CHAIRMAN OF THE BOARD |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. CARROLL C. HAMNER, 1420 WABASH AVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
VICE PRESIDENT |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MRS. GAZELLA SUMMITT, 507 GROUSELAND DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Female
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
SECRETARY |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MRS. JANICE L. BEESLEY, 1209 VISTA DRIVE, WASHINGTON, IN 47501 |
2. Gender (male or female) |
Female
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. DONALD G. BELL, 705 NORTH ATKINSON ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. JAMES W. BOBE, 3886 SOUTH MIDDLE HART STREET, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. JOHN BOBE, 1471 NORTH NEWELL ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. MIKE BONEWITZ, 2210 NORTH BALLA MACHRE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. L. KIRK BOUCHIE, 1622 MONTCLAIR DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. MIKE A. BURCH, 1565 NORTH MCCLURE ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. BRENT D. COURTER, R. R. 3, BOX 25, SHOALS, IN 47581 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MRS. CHRISTINA ERNST, 1221 OLD ORCHARD ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Female
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. HORACE A. FONCANNON, JR, 337 SHANE LANE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
PRESIDENT JOHN R. GREGG, 20566 EAST JERICO ROAD, SANDBORN, IN 47578 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
INTERIM PRESIDENT VINCENNES UNIVERSITY |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. MAC MCCORMICK, 816 BUNTIN STREET, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MRS. JOYCE MEMERING, 1801 MARGARET DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Female
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. DAVID L. MILLER, 109 HENDRON HILLS DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. DAN J. NICOSON, 911 NORTH HONEYSUCKLE LANE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
PRESIDENT VINCENNES UNIVERSTIY FOUNDATION |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. BERNARD G. NIEHAUS, 100 LAKEWOOD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. MICHAEL L. NIEMEYER, 1506 FRANKLIN DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JUDGE JIM R. OSBORNE, 502 BROADWAY STREET, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. PHIL RATH, 1422 OLD ORCHARD ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. GEORGE REHNQUIST, PO BOX 1265, PRINCETON, IN 47670 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. DAN J. ROBINSON, 1094 SOUTH STATE ROAD 241, WHEATLAND, IN 47597 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. GERVASE SCHWENK, 1665 W. STATE ROAD 56, JASPER, IN 47546 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. DAVID B. SKINNER, 3042 EAST STATE ROAD 61, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. ROBERT J. STRYZINSKI, 107 HENDRON HILLS DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. BRENT STUCKEY, 2540 GRANDVIEW DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. GREGORY W. STURM, 351 NORTH DEER CREEK DRIVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. P. R. SWEENEY, 2899 SOUTH HICKORY CORNER ROAD, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. WILLIAM E. UPDIKE, 4801 PLANTATION DRIVE, INDIANAPOLIS, IN 46250 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
DR. WILLIAM R. VAUGHN, 200 SOUTH SIXTH STREET, VINCENNES, IN 47591 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MR. JAMES D. WINEMILLER, 8084 RIVER BAY DRIVE WEST, INDIANAPOLIS, IN 46240 |
2. Gender (male or female) |
Male
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MRS. JAYNE BIERHAUS YOUNG, 2630 TURLEY AVE, VINCENNES, IN 47591 |
2. Gender (male or female) |
Female
|
3. Ethnicity (check one) |
Hispanic or Latino
Not Hispanic or Latino |
4. Race (select one or more) |
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
|
5. Citizenship |
US |
6. Positional Interest |
MEMBER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
|
(b) |
Respondent certifies that equity and financial interests not set forth in response to Question 9(a) are non-attributable. |
Yes No
N/A
See Explanation in
[Exhibit 2]
|
(c) |
Is the respondent or any party holding an attributable interest in the respondent also the holder of an attributable interest in any other broadcast station or in any cable or newspaper entities in the same market or with overlapping signals in the same broadcast service, as described in 47 C.F.R. Sections 73.3555 and 76.501? |
Yes No |
If "Yes", submit an Exhibit identifying the holder of that other attributable interest, listing the call signs, locations and facilities identifiers of such other broadcast stations, and describing the nature and size of the ownership interest and the positions held in the other broadcast, cable or newspaper entities. |
[Exhibit 3] |
(d) |
Are any of the individuals listed in response to Question 9(a) related as parent-child, husband-wife, brothers and sisters?
|
Yes No
|
|
If "Yes", submit an Exhibit setting forth full information as to the family relationship
|
[Exhibit 4]
|
(e) |
Is respondent seeking an attribution exemption for any officer or director with duties unrelated to the licensee or permittee?
If "Yes", submit an Exhibit identifying that individual by name and title, fully describing that individual's duties and responsibilities, and explaining why that individual should not be attributed an interest.
|
Yes No
[Exhibit 5]
|
|