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.

BON - 20040927AHL
Section I - General
1. Legal Name of the Licensee/Permittee
BOARD OF GOVERNORS OF SOUTHWEST MISSOURI STATE UNIVERSITY
Mailing Address
901 S. NATIONAL AVE.
City
SPRINGFIELD
State or Country (if foreign address)
MO
ZIP Code
65804 - 0089
Telephone Number (include area code)
4178365878
E-Mail Address (if available) 
ARLENDIAMOND@SMSU.EDU
FCC Registration Number:
0002487056
Call Sign 
KSMU
Facility ID Number 
51102
2. Contact Representative (if other than Licensee/Permittee)
MARGARET L. MILLER
Firm or Company Name
DOW, LOHNES & ALBERTSON, PLLC
Mailing Address

City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
2027762000
E-Mail Address (if available)
MMILLER@DOWLOHNES.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 09/03/2004 (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
KSMU 4210 SPRINGFIELD MO FM

Call Letters
Facility ID Number
Location (City/State)
Class of service
KSMS-FM 61519 POINT LOOKOUT MO FM

Call Letters
Facility ID Number
Location (City/State)
Class of service
KSMW 94057 WEST PLAINS MO FM

Call Letters
Facility ID Number
Location (City/State)
Class of service
KOZK 51102 SPRINGFIELD MO TV

Call Letters
Facility ID Number
Location (City/State)
Class of service
KOZJ 51101 JOPLIN MO TV


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)
NATIONAL PUBLIC RADIO AFFILIATION AGREEMENT NATIONAL PUBLIC RADIO 10/01/1988 NONE

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)
ANNUAL MEMBERSHIP CERTIFICATION OF GOOD STANDING PUBLIC BROADCASTING SERVICE 05/07/2001 NONE


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. BARBARA D. BURNS, 1500 SOUTH BROADWAY, LAMAR, MO 64759
b. Citizenship. US

c. Office held.

PRESIDENT OF THE BOARD

d. Percent of interest held.

0.00

e. Principal profession or occupation.

EDUCATOR

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. WILLIAM H. DARR, PO BOX 4087, SPRINGFIELD,MO 65808
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESSMAN

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. MICHAEL FRANKS, P.O. BOX 250 NEOSHO, MO 64850
b. Citizenship. US

c. Office held.

VICE PRESIDENT OF THE BOARD

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESSMAN

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. JOHN H. KEISER, 901 SOUTH NATIONAL SPRINGFIELD, MO 65804
b. Citizenship. US

c. Office held.

PRESIDENT, SMSU

d. Percent of interest held.

0.00

e. Principal profession or occupation.

EDUCATOR

f. By whom appointed or elected.

BOARD OF GOVERNORS

g. Existing interests

NONE

a. Name and Address. GREG BURRIS,901 SOUTH NATIONAL SPRINGFIELD,MO 65804
b. Citizenship. US

c. Office held.

VICE PRESIDENT, SMSU

d. Percent of interest held.

0.00

e. Principal profession or occupation.

UNIVERSITY ADMINISTRATOR

f. By whom appointed or elected.

BOARD OF GOVERNORS

g. Existing interests

NONE

a. Name and Address. THOMAS J. CARLSON, 205 WEST WALNUT STREET, SUITE 200, SPRINGFIELD, MO 65806
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ATTORNEY

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. MICHAEL J. DUGGAN, 17720 GREYSTONE TERRACE DRIVE, CHESTERFIELD, MO 63005-4225
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESSMAN

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. MARY SHEID, 1913 CAMBRIDGE, WEST PLAINS MO 65775
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BUSINESSWOMAN

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. PHYLLIS WASHINGTON, 706 WEST 42ND STREET, KANSAS CITY, MO 64111
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

EDUCATOR

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. KELLI A. WOLF, 901 SOUTH NATIONAL, PSU-ROOM 123, SPRINGFIELD MO 65804
b. Citizenship. US

c. Office held.

NA

d. Percent of interest held.

0.00

e. Principal profession or occupation.

STUDENT

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE

a. Name and Address. D. KENT KING, PO BOX 480, JEFFERSON CITY, MO 65102-0480
b. Citizenship. US

c. Office held.

EX OFFICIO

d. Percent of interest held.

0.00

e. Principal profession or occupation.

COMMISSIONER OF EDUCATION

f. By whom appointed or elected.

GOVERNOR OF MISSOURI

g. Existing interests

NONE




SECTION III - CERTIFICATION


I certify that I am VP OF ADMINISTRATION AND FINANCE

(Official Title)


of SOUTHWEST MISSOURI STATE UNIVERSITY

(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
GREG BURRIS
Date
09/21/2004
Telephone Number of Respondent (Include area code) 4178365233


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