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 |
NANCY DOBBS, 5850 LABATH AVENUE, ROHNERT PARK, CALIFORNIA 94928 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
LARRY STRATTON, 5850 LABATH AVENUE, ROHNERT PARK, CALIFORNIA 94928 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
JEAN HACKENBURG, 4000 PETALUMA HILL ROAD, SANTA ROSA, CALIFORNIA 95404 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
PATRICK CAMPBELL P.O. BOX 1419, GLEN ELLEN, CALIFORNIA 95442 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
MIKE R. MUSSON, LINKENHEIMER LLP, FOUNTAINGROVE CORPORATE CENTER, 3510 UNOCAL PLACE, SUITE 300, SANTA ROSA, CALIFORNIA 95403 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
PAUL GINSBURG P.O. BOX 1774, 50 SHADY LANE, ROSS, CALIFORNIA 94957 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
MARLENE BALLAINE, 811 KING SREET, SANTA ROSA, CALIFORNIA 95404 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
STEVE DELAP, 4304 PRINCETON WAY, SANTA ROSA, CALIFORNIA 95405 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
DAVID GRENEWETZKI, 37 OAK VALLEY DRIVE, NOVATO, CALIFORNIA 94947 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
JOHN KRAMER, 1256 RIM OF THE REDWOODS, SEBASTOPOL, CALIFORNIA 95472 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
CAROL LIBARLE, 1319 I STREET, PETALUMA, CALIFORNIA 94952 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
JOSUE LOPEZ, 141 STONY CIRCLE, SUITE 150, SANTA ROSA, CALIFORNIA 95401-4109 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
HOWARD NURSE, P.O. BOX 1438, HEALDSBURG, CALIFORNIA 95448 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
RAFAEL RIVERO, 4209 QUIMBY STREET, SANTA ROSA, CALIFORNIA 95407 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
GORDON STEWART, 8456 KENNEDY ROAD, SEBASTOPOL, CALIFORNIA 95472 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
1. Name and Address |
JEAN WASP, SONOMA STATE UNIVERSITY, 1801 EAST COTATI AVENUE, ROHNERT PARK, CALIFORNIA 94928 |
2. Gender (male or 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 |
|
7. Percentage of votes |
|
8. Percentage of total assets (equity debt plus) |
|
|
(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]
|
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