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 |
DELMER WAGNER; 36505 DITCH CREEK ROAD; ROGUE RIVER, OR 97526 |
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, DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
ROBERT L. HEISLER; 747 CAROLLWOOD DRIVE; GRANTS PASS, OR 97527 |
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, DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
OLEN NATIONS; 3013 PEARCE PARK ROAD; GRANTS PASS, OR 97526 |
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 |
SECRETARY, DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
DON EISNER; P O BOX 5746; GRANTS PASS, OR 97527-0746 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
KEITH BABCOCK; 953 ARNOLD LANE; MEDFORD, OR 97501 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
RON BECHTEL; 3424 DELTA WATERS ROAD; MEDFORD, OR 97504 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
LYLE COCHRAN; 81 MOUNTAIN DR.;ROSEBURG, OR 97470 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
PAUL GORDON; 613 SILVERADO WAY; EAGLE POINT, OR 97524 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
HOLLY RUEB; 13603 MODOC ROAD; WHITE CITY, OR 97503 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
DR. WALTER MACPHEE; 255 BRUSH CREEK ROAD; CRESCENT CITY, CA 95531 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MERRITT HURST; P O BOX 449;MALIN, OR 97632 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
RICHARD SURROZ; P O BOX 1142; GRANTS PASS, OR 97528 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JUDY RANDAHL; P O BOX 5239; CENTRAL POINT, OR 97502 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
BOB STARCHER; 1487 SOUTH OAKDALE; MEDFORD, OR 97501 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
GEORGE WHITE; 1088 COACHMAN DRIVE; CENTRAL POINT, OR 97502 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
DR. WILLARD REGESTER; 11989 WILLIAMS HIGHWAY; GRANTS PASS, OR 97527 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
PATTY HYLAND, 6661 LOWER RIVER ROAD, GRANTS PASS, OR 97526 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
BOB MCREYNOLDS, 93341 BEAVER CREEK LANE, COOS BAY, OR 97420 |
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 |
DIRECTOR |
7. Percentage of votes |
5.50 |
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]
|
|