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 |
ELCOM OF VIRGINIA LICENSE SUBSIDIARY, LLC, C/O RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
2. Gender (male or female) |
N/A
|
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 |
RESPONDENT |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
ELCOM OF VIRGINIA, LLC, C/O RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
2. Gender (male or female) |
N/A
|
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 |
SOLE MEMBER |
7. Percentage of votes |
100.00 |
8. Percentage of total assets (equity debt plus) |
100.00 |
1. Name and Address |
PAUL H. MCTEAR, JR., RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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, TREASURER & DIRECTOR |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
WAYNE DAUGHERTY, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
EXECUTIVE VICE PRESIDENT, COO |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MARTY EDELMAN, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
SENIOR VICE PRESIDENT, TELEVISION |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
LEON LONG, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
SENIOR VICE PRESIDENT, TELEVISION |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JEFF ROSSER, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
SENIOR VICE PRESIDENT, TELEVISION |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
REBECCA S. BRYAN, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
VICE PRESIDENT, SECRETARY & DIRECTOR |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MELISSA THURBER, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
VICE PRESIDENT, ASSISTANT SECRETARY |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
J. CLYDE BAUCOM, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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, HUMAN RESOURCES |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
DAVID FOLSOM, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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, CHIEF TECHNOLOGY OFFICER |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
ANNE ADKINS, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
VICE PRESIDENT, MARKETING |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
SUSANA WILLINGHAM, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
VICE PRESIDENT, NEWS |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
MARY CAROLE MCDONNELL, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
VICE PRESIDENT, PROGRAMMING |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
WILLIAM R. (BILLY) MCDOWELL, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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, RESEARCH |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
JOHN ALEXANDER, RAYCOM MEDIA, INC., RSA TOWER, 20TH FLOOR, 201 MONROE ST., MONTGOMERY, AL |
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 |
ASSISTANT SECRETARY |
7. Percentage of votes |
0.00 |
8. Percentage of total assets (equity debt plus) |
0.00 |
1. Name and Address |
PETER MARONEY, WTVR-TV, 3301 WEST BROAD STREET, RICHMOND, VA |
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 & GENERAL MANAGER OF WTVR-TV |
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]
|
|