Free 323-E - Federal

Federal Communications Commission Washington, D. C. 20554

Approved by OMB 3060-0084

FCC 323-E INSTRUCTIONS FOR OWNERSHIP REPORT GENERAL INSTRUCTIONS 1. This report is to be filed by non-commercial educational FM and Television broadcast stations as indicated below (see 47 C.F.R. Section 73.3615). (a) By licensees on the anniversary date of the station's renewal application filing date and every two years thereafter. If information submitted is equally applicable to each listed station, one annual report may be filed for all such stations; otherwise, a separate report shall be filed for each station on the appropriate filing date. If there has been no change since the filing of the last biennial report, a certification may be filed in lieu of a new report, stating that the previously filed report has been examined and is currently accurate. (b) By permittee or licensee following the consummation, pursuant to Commission consent, of a transfer of control or an assignment of license/permit. (c) By permittee within 30 days after the grant of a construction permit for a new non-commercial educational radio or television broadcast station. The permittee is also required to update its initial report or to certify the continuing accuracy and completeness of that report when the permittee applies for a station license for that new station. 2. Electronic Filing of Application Forms. The Commission is currently developing electronic versions of various broadcast station application and reporting forms, such as this report form. As each application form and report goes online, the Commission will by Public Notice announce its availability and the procedures to be followed for accessing and filing the application form or report electronically via the Internet. For a six-month period following the issuance of the Public Notice, the subject application form or report can be filed with the Commission either electronically or in a paper format. Electronic filing will become mandatory, on a form-by-form basis, six months after each application form or report becomes available for filing electronically. File one copy of this report with the Federal Communications Commission. Form 323-E's can be 5. hand-delivered or mailed to the FCC's Washington, D.C. offices. See 47 C.F.R. Section 0.401(a). 4. Any contract or modification of contract relating to the ownership, control, or management of the licensee or permittee must be filed with the Commission, as required by 47 C.F.R. Section 73.3613. Attention is directed to the fact that Section 73.3613 requires the filing of all contracts of the types specified and is not limited to executed contracts, but includes options, pledges, and other executory agreements and contracts relating to ownership, control or management. This form should be used to report all types of transactions concerning agreements and voting control. If the licensee or permittee is directly or indirectly controlled by another entity, a separate Form 323-E should be submitted for such entity. This form is not to be used to report or request a transfer of control or assignment of license or construction permit (except to report a transfer of control or assignment made pursuant to prior Commission consent). The appropriate forms for use in connection with such transfers or assignments are FCC Forms 314, 315 and 316. It is the prime responsibility of the licensee or permittee to determine whether a given transaction constitutes a transfer of control or an assignment. The official title of the respondent must be an officer of the licensee or permittee corporation or association, or in case of a governmental or public educational agency, a duly authorized administrative representative thereof. FCC Registration Number (FRN). To comply with the Debt Collection Improvement Act of 1996, the applicant must enter its FRN number, a ten-digit unique entity identifier for anyone doing business with the Commission. The FRN can be obtained through the FCC webpage at http://www.fcc.gov or by manually submitting FCC Form 160. FCC Form 160 is available for downloading from http://www.fcc.gov/formpage. html or by calling 1-800-418-3676. Questions concerning the FCC Registration Number can be directed to the Commission's Registration System help desk at http://[email protected] or by calling 1-877480-3201. Facility ID Number. Radio and TV Facility ID Numbers can be obtained at the FCC's Internet Website at www.fcc.gov/mmb. Once at this website, scroll down FCC 323-E June 2002

6.

7.

8.

9. 3.

All previous editions obsolete.

and select CDBS Public Access. You can also obtain your facility ID number by calling: Radio - 202-4182700, TV - 202-418-1600. Further, the Facility ID Number is now included on all Radio and TV authorizations and postcards. FCC NOTICE TO INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT The FCC is authorized under the Communications Act of 1934, as amended to collect the personal information requested in this report. We will use the information provided in this report to assess compliance with the Commission's regulations and policies. If we believe there may be a violation or potential violation of a FCC statute, regulation, rule or order, your report may be referred to the Federal, state or local agency responsible for investigating, prosecuting, enforcing or implementing the statute, rule, regulation or order. In certain cases, the information in your report may be disclosed to the Department of Justice or a court or adjudicative body when (a) the FCC; (b) any employee of the FCC; or (c) the United States Government is a party to a proceeding before the body or has an interest in the proceeding. In addition, all information provided in this form will be available for public inspection. If you owe a past due debt to the federal government, any information you provide may also be disclosed to the Department of Treasury Financial Management Service, other federal agencies and/or your employer to offset your salary, IRS tax refund or other payments to collect that debt. The FCC may also provide this information to these agencies through the matching of computer records when authorized. If you do not provide the information requested on this form, the report may be returned without action having been taken upon it or its processing may be delayed while a request is made to provide the missing information. Your response is required to obtain the requested authorization. We have estimated that each response to this collection of information will take 4 hours. Our estimate includes the time

to read the instructions, look through existing records, gather and maintain the required data, and actually complete and review the form or response. If you have any comments on this estimate, or on how we can improve the collection and reduce the burden it causes you, please write the Federal Communications Commission, AMD-PERM, Paperwork Reduction Project (3060-0084), Washington, DC 20554. We will also accept your comments via the Internet if your send them to [email protected]. Please DO NOT SEND COMPLETED APPLICATIONS TO THIS ADDRESS. Remember - you are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number of if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060-0084. THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, P.L. 93-579, DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3), AND THE PAPERWORK REDUCTION ACT OF 1995, P.L. 104-13, OCTOBER 1, 1995, 44 U.S.C. 3507.

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Federal Communications Commission Washington, D. C. 20554

FCC 323-E OWNERSHIP REPORT FOR NONCOMMERCIAL BROADCAST STATIONS

Approved by OMB 3060-0084

FOR FCC USE ONLY

FOR COMMISSION USE ONLY

SECTION I - GENERAL INFORMATION 1. Legal Name of the Licensee/Permittee Mailing Address City Telephone Number (include area code) FCC Registration Number

FILE NO.

State or Country (if foreign address) E-Mail Address (if available) Facility ID Number

ZIP Code

Call Sign

2.

Contact Representative (if other than Licensee/Permittee) Mailing Address City Telephone Number (include area code)

Firm or Company Name

State or Country (if foreign address) E-Mail Address (if available)

ZIP Code

3.

Name of entity, if other than licensee or permittee, for which report is filed Mailing Address City Telephone Number (include area code) State or Country (if foreign address) E-Mail Address (if available) ZIP Code

SECTION II - OWNERSHIP INFORMATION 4. All of the information furnished in this Report is accurate as of ______________________________________________ (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 Location c. Other

for the following stations: Call Letters Facility ID Number Class of service

All previous editions obsolete.

FCC 323-E June 2002

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.) Description of contract or instrument Name of person or organization with whom contract is made Date of Execution Date of Expiration

6.

Is the governing board directly or indirectly under the control of another entity? If Yes, is a separate FCC Form 323-E submitted for such entity?

Yes Yes

No 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. (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 thereeafter, holders of 1% or more ownership interest, if any. Citizenship. Office held.

d. e. f. g.

Percent of interest held. Principal profession or occupation. By whom appointed or elected. Existing interests in any other broadcast station, including the nature and size of such interests.

b. c.

a.

b. c. d. e.

f.

g.

FCC 323-E (Page 2) June 2002

SUPPLEMENTAL PAGE FOR QUESTION 7.

a.

b. c. d. e.

f.

g.

a.

b. c. d. e.

f.

g.

FCC 323-E (Page 3) June 2002

SECTION III - CERTIFICATION I certify that I am (Official Title) of (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 Date

Telephone Number of Respondent (Include area code)

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).

FCC 323-E (Page 4) June 2002