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.

BOA - 20091112AAZ
Section I - General
1. Legal Name of the Licensee/Permittee
NORTHERN MINNESOTA PUBLIC TELEVISION, INC.
Mailing Address
BSU BOX 9
1500 BIRCHMONT DRIVE
City
BEMIDJI
State or Country (if foreign address)
MN
ZIP Code
56601 -
Telephone Number (include area code)
2187513407
E-Mail Address (if available) 
BSANFORD@LAKELANDPTV.ORG
FCC Registration Number:
0003916293
Call Sign 
Facility ID Number 
49578
2. Contact Representative (if other than Licensee/Permittee)
TODD D. GRAY
Firm or Company Name
DOW, LOHNES & ALBERTSON
Mailing Address

City
State or Country (if foreign address)
ZIP Code
-
Telephone Number (include area code)
2027762000
E-Mail Address (if available)
TGRAY@DOWLOHNES.COM
3. Name of entity, if other than licensee or permittee, for which report is filed
NNORTHERN MINNESOTA PUBLIC TELEVISION, INC.
Mailing Address
1500 BIRCHMONT DRIVE NE #9

City
BEMIDJI
State or Country (if foreign address)
MN
ZIP Code
56601 -
Telephone Number (include area code)
2183333015
E-Mail Address (if available)
BSANFORD@LPTV.ORG



Section II - Ownership Information

4.
All of the information furnished in this Report is accurate as of 11/11/2009 (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
KAWE 49578 BEMIDJI MN TV

Call Letters
Facility ID Number
Location (City/State)
Class of service
KAWB 49579 BRAINERD MN 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)
NMPTV ARTICLES OF INCORPORATION STATE OF MN 10/14/1970 N/A

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)
NMPTV AMMENDMENT TO ARTICLES OF INCORPORATION STATE OF MN 06/29/1976 N/A

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)
NMPTV BYLAWS STATE OF MN 03/01/2006 N/A

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)
PBS MEMBERSHIP CERTIFICATION PBS 07/21/2009 N/A


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. TRAVIS ANNETTE, 3511 CEDAR LANE NW, BEMIDJI, MN 56601
b. Citizenship. US

c. Office held.

PRESIDENT

d. Percent of interest held.

0.00

e. Principal profession or occupation.

COURTS ADMINISTRATOR

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. SUE KRINGEN, 50645 COUNTY 3, BEMIDJI, MN 56601
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

BANKING

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. RAY GILDOW, 12880 267TH AVE, STAPLES, MN 56479
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED EDUCATOR

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. GERRY BRINE, PO BOX 720, CROSS LAKE, MN 56422
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ATTORNEY

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. ROLLIN BUCK, 461 TYRON DRIVE, BRAINERD, MN 56401
b. Citizenship. US

c. Office held.

PRESIDENT

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ACCOUNTING / TAX PREP.

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. DR JIM HESS, 3601 BIRCHMONT DRIVE NE, BEMIDJI, MN 56601
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

SCHOOL SUPERINTENDENT

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. WILLIAM M. SANFORD, 4497 CARVER RD NE, BEMIDJI, MN 56601
b. Citizenship. US

c. Office held.

GENERAL MANAGER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

MANAGER

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

AS THE GENERAL MANAGER. MR. SANFORD IS AUTHORIZED BY THE BOARD TO EXECUTE AND CERTIFY LEGAL DOCUMENTS, INCLUDING FCC APPLICATIONS, ON BEHALF OF THE LICENSEE.

a. Name and Address. SUSAN HOLDEN, 2498 TOURNAMENT PLAYERS CIRCLE S, BLAINE, MN 55449
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ATTORNEY

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. STEVE HOWARD - 48349 309TH AVE, LAPORTE, MN 56461
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

IT MANAGER

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. PAUL HUNT - 2322 DANCING WIND RD SW, PINE RIVER, MN 56474
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

ENERGY & UTILITY R & D

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. PAM LANDERS - 26587 EDNA LAKE RD, NISSWA, MN 56468
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED EDUCATOR

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A

a. Name and Address. JAMES H PITT - 37054 DEER STREET, AITKIN, MN 56431
b. Citizenship. US

c. Office held.

BOARD MEMBER

d. Percent of interest held.

0.00

e. Principal profession or occupation.

RETIRED EDUCATOR

f. By whom appointed or elected.

BOARD APPOINTMENT

g. Existing interests

N/A




SECTION III - CERTIFICATION


I certify that I am GENERAL MANAGER

(Official Title)


of NORTHERN MINNESOTA PUBLIC TELEVISION, INC.

(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
WILLIAM M. SANFORD
Date
11/11/2009
Telephone Number of Respondent (Include area code) 2183333015


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