FRN | Entity Name |
---|---|
0031130370 |
Chelan Valley Media Group LLC |
Street Address | City (and Country if non U.S. address) | State ("NA" if non-U.S. address) | Zip Code | Phone | |
---|---|---|---|---|---|
PO Box 1416 |
Chelan |
WA |
98816 |
+1 (206) 399-8716 |
karenheric@kozi.com |
Name | Organization |
---|---|
David G. O'Neil, Esq. |
Rini O'Neil, PC |
Street Address | City (and Country if non U.S. address) | State | Zip Code | Phone | |
---|---|---|---|---|---|
2101 L Street, NW Suite 300 |
Washington |
DC |
20037 |
+1 (202) 955-3931 |
doneil@rinioneil.com |
(a) Provide the following information about the Respondent: | ||
---|---|---|
Relationship to stations/permits |
Licensee |
|
Nature of Respondent |
Limited liability company |
(b) Provide the following information about this report: | |
---|---|
Purpose | Transfer of control or assignment of license/permit |
"As of" date | 11/28/2021 When filing a biennial ownership report or validating and resubmitting a prior biennial ownership report, this date must be Oct. 1 of the year in which this report is filed. |
Licensee/Permittee Name | FRN |
---|---|
Chelan Valley Media Group LLC | 0031130370 |
Fac. ID No. | Call Sign | City | State | Service |
---|---|---|---|---|
49366 | KOZI-FM | CHELAN | WA | FM |
49370 | KOZI | CHELAN | WA | AM |
162412 | KZAL | MANSON | WA | FM |
Document Information | |
---|---|
Description of contract or instrument | Certificate of Formation |
Parties to contract or instrument | State of Washington |
Date of execution | 05/2021 |
Date of expiration | 05/2022 |
Agreement type (check all that apply) |
Other
Agreement Type: Governance Document |
Document Information | |
---|---|
Description of contract or instrument | Limited Liability Company Agreement |
Parties to contract or instrument | Chelan Valley Media Group LLC |
Date of execution | 05/2021 |
Date of expiration | No expiration date |
Agreement type (check all that apply) |
Other
Agreement Type: Governance Document |
(a) Ownership Interests. This Question requires Respondents to enter detailed information about ownership interests by generating a series of subforms. Answer each question on each subform. The first subform listing should be for the Respondent itself. If the Respondent is not a natural person, also list each of the officers, directors, stockholders, non-insulated partners, non-insulated members, and any other persons or entities with a direct attributable interest in the Respondent pursuant to the standards set forth in 47 C.F.R. Section 73.3555. (A “direct” interest is one that is not held through any intervening companies or entities.) List each interest holder with a direct attributable interest in the Respondent separately.
Leave the percentage of total assets (Equity Debt Plus) field blank for an interest holder unless that interest holder has an attributable interest in the Respondent solely on the basis of the Commission’s Equity Debt Plus attribution standard, 47 C.F.R. Section 73.3555, Note 2(i).
In the case of vertical or indirect ownership structures, list only those interests in the Respondent that also represent an attributable interest in the Licensee(s) or Permittee(s) for which the report is being submitted.
Entities that are part of an organizational structure that includes holding companies or other forms of indirect ownership must file separate ownership reports. In such a structure do not report, or file a separate report for, any interest holder that does not have an attributable interest in the Licensee(s) or Permittee(s) for which the report is being submitted.
Please see the Instructions for further detail concerning interests that must be reported in response to this question.
The Respondent must provide an FCC Registration Number for each interest holder reported in response to this question. Please see the Instructions for detailed information and guidance concerning this requirement.
Ownership Information | |||
---|---|---|---|
FRN | 0031130370 | ||
Entity Name | Chelan Valley Media Group LLC | ||
Address | PO Box | 1416 | |
Street 1 | |||
Street 2 | |||
City | Chelan | ||
State ("NA" if non-U.S. address) | WA | ||
Zip/Postal Code | 98816 | ||
Country (if non-U.S. address) | United States | ||
Listing Type |
Respondent |
||
Positional Interests |
Respondent | ||
Interest Percentages (enter percentage values from 0.0 to 100.0) |
Voting | 0.0% |
Jointly Held?
No |
Total assets (Equity Debt Plus) | 0.0% | ||
Does interest holder have an attributable interest in one or more broadcast stations that do not appear on this report? |
No |
Ownership Information | |||
---|---|---|---|
FRN | 0031684095 | ||
Name | Melissa D. Davis | ||
Address | PO Box | ||
Street 1 | 5028 47th Avenue NE | ||
Street 2 | |||
City | Seattle | ||
State ("NA" if non-U.S. address) | WA | ||
Zip/Postal Code | 98105 | ||
Country (if non-U.S. address) | United States | ||
Listing Type |
Other Interest Holder |
||
Positional Interests |
LC/LLC/PLLC Member | ||
Interest Percentages (enter percentage values from 0.0 to 100.0) |
Voting | 25.0% |
Jointly Held?
No |
Total assets (Equity Debt Plus) | 25.0% | ||
Does interest holder have an attributable interest in one or more broadcast stations that do not appear on this report? |
No |
Ownership Information | |||
---|---|---|---|
FRN | 0031684160 | ||
Name | Karen Heric | ||
Address | PO Box | ||
Street 1 | 50 Harris Row | ||
Street 2 | |||
City | Manson | ||
State ("NA" if non-U.S. address) | WA | ||
Zip/Postal Code | 98831 | ||
Country (if non-U.S. address) | United States | ||
Listing Type |
Other Interest Holder |
||
Positional Interests |
LC/LLC/PLLC Member | ||
Interest Percentages (enter percentage values from 0.0 to 100.0) |
Voting | 25.0% |
Jointly Held?
No |
Total assets (Equity Debt Plus) | 25.0% | ||
Does interest holder have an attributable interest in one or more broadcast stations that do not appear on this report? |
No |
Ownership Information | |||
---|---|---|---|
FRN | 0031684178 | ||
Name | Matthew Peters | ||
Address | PO Box | ||
Street 1 | 137 Summer Breeze Road | ||
Street 2 | |||
City | Manson | ||
State ("NA" if non-U.S. address) | WA | ||
Zip/Postal Code | 98331 | ||
Country (if non-U.S. address) | United States | ||
Listing Type |
Other Interest Holder |
||
Positional Interests |
LC/LLC/PLLC Member | ||
Interest Percentages (enter percentage values from 0.0 to 100.0) |
Voting | 25.0% |
Jointly Held?
No |
Total assets (Equity Debt Plus) | 25.0% | ||
Does interest holder have an attributable interest in one or more broadcast stations that do not appear on this report? |
No |
Ownership Information | |||
---|---|---|---|
FRN | 0031687320 | ||
Entity Name | Allan C. Mayer Jr. Exempt Descendants Trust | ||
Address | PO Box | 941 | |
Street 1 | |||
Street 2 | |||
City | Manson | ||
State ("NA" if non-U.S. address) | WA | ||
Zip/Postal Code | 98331 | ||
Country (if non-U.S. address) | United States | ||
Listing Type |
Other Interest Holder |
||
Positional Interests |
LC/LLC/PLLC Member | ||
Interest Percentages (enter percentage values from 0.0 to 100.0) |
Voting | 25.0% |
Jointly Held?
No |
Total assets (Equity Debt Plus) | 25.0% | ||
Does interest holder have an attributable interest in one or more broadcast stations that do not appear on this report? |
No |
(b) Respondent certifies that any interests, including equity, financial, or voting interests, not reported in this filing are non-attributable.
If "No," submit as an exhibit an explanation. |
Yes |
(c) Does the Respondent or any reported interest holder hold an attributable interest in any newspaper entities in the same market as any station for which this report is filed, as defined in 47 C.F.R. Section 73.3555? If "Yes," provide information describing the interest(s), using EITHER the subform OR the spreadsheet option below. Respondents with a large number (50 or more) of entries to submit should use the spreadsheet option. NOTE: Spreadsheets must be submitted in a special XML Spreadsheet format with the appropriate structure that is specified in the documentation. For instructions on how to use the spreadsheet option to complete this question (including templates to start with), please Click Here. If using the subform, leave the percentage of total assets (Equity Debt Plus) field blank for an interest holder unless that interest holder has an attributable interest in the newspaper entity solely on the basis of the Commission’s Equity Debt Plus attribution standard, 47 C.F.R. Section 73.3555, Note 2(i). If using an XML Spreadsheet, enter “NA” into the percentage of total assets (Equity Debt Plus) field for an interest holder unless that interest holder has an attributable interest in the newspaper entity solely on the basis of the Commission’s Equity Debt Plus attribution standard. The Respondent must provide an FCC Registration Number for each interest holder reported in response to this question. Please see the Instructions for detailed information and guidance concerning this requirement. |
No |
(d) Are any of the individuals listed as an attributable interest holder in the Respondent married to each other or related to each other as parent‐child or as siblings?
If "Yes," provide the following information for each such the relationship. |
No |
(e) Is Respondent seeking an attribution exemption for any officer or director with duties wholly unrelated to the Licensee(s)? If "Yes," complete the information in the required fields and submit an Exhibit fully describing that individual’s duties and responsibilities, and explaining why that individual should not be attributed an interest. |
No |
Section | Question | Response |
---|---|---|
Authorized Party to Sign | 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). |
|
Certification | I certify 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. | Official Title: President Exact Legal Title or Name of Respondent: Chelan Valley Media Group LLC Name: Karen Heric Phone: 2063998716 11/30/2021 |