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 |
MARY E. ANDERSON 112 SOUTH SIXTH ST. OSBORNE, KS. 67473 |
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 |
PEGGY CHRISLER 1416 N. CULP RUSSELL, KS. 67665 |
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 |
DR. MARGARET BUTCHER 2700 CUNNINGHAM DODGE CITY, KS. 67801 |
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 |
RANDY J. COLEMAN 403 W. 9TH ST. GOODLAND, KS. 67735 |
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 |
LOU CAPLAN 2003 MAIN HAYS, KS. 67601 |
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 |
CYNTHIA A. ELLIOTT 3000 COLUMBINE HAYS, KS. 67601 |
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 CAVANAUGH 5103 TELATRA LANE GREATBEND, KS. 67530 |
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 |
SHEILA FRAHM 410 N. GRANT AVE. COLBY, KS. 67701 |
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 |
NEAL HAERICH 803 GRANT ST. VICTORIA, KS. 67671 |
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 |
TAYLOR SUMMERS 707 N. MCCALL ST. ULYSSES, KS. 67880 |
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 |
EARNEST A. LEHMAN 3705 FAIWAY DR. HAYS, KS. 67601 |
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 |
MARY ANN TANKING 2210 EDGEHILL RD. SALINA, KS. 67401 |
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 |
FLORENCE METCALF 8051 ROAD G LIBERAL, KS. 67901 |
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 |
LUANNE THELEMAN 2242 S. 260TH AVE. NATOMA, KS. 67651 |
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 |
JAMES MILLENSIFER 171 CO RD 34 OAKLEY, KS. 67748 |
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 |
RANDALL W. WELLER PO BOX 159 HIGHWAY 283 S. HILL CITY, KS. 67642 |
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 |
MICHAEL QUADE 265 S. GRENN HOISINGTON, KS. 67544 |
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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