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Licensing and Management System

Approved by OMB 3060-0084
July 2019
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)Noncommercial Broadcast Stations Biennial Ownership Report (FCC Form 323-E)

File Number:
0000175138
Submit Date:
2021-12-01
FRN:
0016632697
Purpose:
Noncommercial Broadcast Stations Biennial Ownership Report
Status:
Received
Status Date:
12/01/2021
Filing Status:
Active

Section I - General Information

1. Respondent

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FRN Entity Name

0016632697

Inter Mirifica, Inc.

Street Address City (and Country if non U.S. address) State ("NA" if non-U.S. address) Zip Code Phone Email

8383 Craig Street, Suite 280

Indianapolis

IN

46250

+1 (317) 870-8400

Bob@TeipenCPA.com

2. Contact Representative

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Name Organization

Stuart W. Nolan, Jr.

LegalWorks Apostolate, PLLC

Street Address City (and Country if non U.S. address) State Zip Code Phone Email

4 Family Life Lane

Front Royal

VA

22630

+1 (540) 622-8070

Nolan@LegalWorks.com

3. Application Filing Fee

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Not Applicable

4. Control of Respondent

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(a) Provide the following information about the Respondent:

Relationship to stations/permits

Licensee

Is the Respondent's governing board (or other governing entity) directly or indirectly under the control of another entity?

No

(b) Provide the following information about this report:
Purpose Biennial
"As of" date 10/01/2021

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.

5. Licensee(s) and Station(s)

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Respondent is filing this report to cover the following Licensee(s) and station(s):
Licensee/Permittee Name FRN
Inter Mirifica, Inc. 0016632697
Fac. ID No. Call Sign City State Service
93486 WSPM CLOVERDALE IN FM
143533 W252CY ANDERSON IN FX
171743 WSQM NOBLESVILLE IN FM

Section II – Biennial Ownership Information

1. 47 C.F.R. Section 73.3613 Documents

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Licensee Respondents that hold authorizations for one or more full power television, AM, and/or FM stations should list all contracts and other instruments set forth in 47 C.F.R. Section 73.3613(a) through (c) for the facility or facilities listed on this report. If the agreement is a network affiliation agreement, check the appropriate box. Otherwise, select “Other.” Non-Licensee Respondents should select “Not Applicable” in response to this question.


Document Information
Description of contract or instrument Articles of Incorporation
Parties to contract or instrument State of Indiana
Date of execution 01/1999
Date of expiration No expiration date
Agreement type
(check all that apply)
Other

Agreement Type: governing document

Document Information
Description of contract or instrument Bylaws
Parties to contract or instrument Inter Mirifica, Inc.
Date of execution 01/1999
Date of expiration No expiration date
Agreement type
(check all that apply)
Other

Agreement Type: governing document

2. Ownership Interests

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(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, members of the governing board (or other governing entity), stockholders, 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) 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) 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 0016632697
Entity Name Inter Mirifica, Inc.
Address PO Box
Street 1 8383 Craig Street, Suite 280
Street 2
City Indianapolis
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46250
Country (if non-U.S. address) United States
Listing Type

Respondent

Positional Interests
(check all that apply)

Respondent
Tribal Nation or Tribal Entity

Interest holder is not a Tribal nation or Tribal entity

Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 0.0%
Equity 0.0%
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 9990132898
Name Robert Teipen
Address PO Box
Street 1 13161 DUVAL DRIVE
Street 2
City Fishers
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46037
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Officer, Other - Chairman of BOD, CEOMember of Governing Board (or other governing entity)
Principal Profession or Occupation Certified Public Accountant
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132899
Name Sharon Teipen
Address PO Box
Street 1 13161 DUVAL DRIVE
Street 2
City Fishers
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46037
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Officer, Other - SecretaryMember of Governing Board (or other governing entity)
Principal Profession or Occupation Homemaker
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Female

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132900
Name James Ganley
Address PO Box
Street 1 12744 HOWE ROAD
Street 2
City Fishers
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46038
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Officer, Other - PresidentMember of Governing Board (or other governing entity)
Principal Profession or Occupation Broadcast Radio Executive
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132901
Name Lee Ashton
Address PO Box
Street 1 1945 Observatory Road
Street 2
City Martinsville
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46151
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Retiree
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132903
Name Paul Habecker
Address PO Box
Street 1 12996 Dreslin Ct.
Street 2
City Fishers
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46037
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Business Owner
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132904
Name Andrew Toth
Address PO Box
Street 1 9020 E Edgewood Ave
Street 2
City Indianapolis
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46239
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation CFO, Gemco Constructors
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132906
Name Dyan Huey
Address PO Box
Street 1 4933 Katelyn Dr
Street 2
City Indianapolis
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46228
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Homemaker
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Female

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132909
Name Gordon Smith
Address PO Box
Street 1 14626 Warner Trail
Street 2
City Westfield
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46074
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Other - General ManagerMember of Governing Board (or other governing entity)
Principal Profession or Occupation Broadcast Executive, General Manager
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990132910
Name Bryan Weiss
Address PO Box
Street 1 4805 Krestridge Ct E
Street 2
City Bargersville
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46106
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Financial Consultant
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990133518
Name George Maley
Address PO Box
Street 1 5392 Thicket Hill Lane
Street 2
City Indianapolis
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46226
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Retiree
By Whom Appointed or Elected Members of the Board
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Male

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990148282
Name Paula Trzepacz
Address PO Box
Street 1 9150 Timberwolf Ln
Street 2
City Zionsville
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46077
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Physician
By Whom Appointed or Elected Board of Directors
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Female

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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 9990148283
Name Lisa Patchner
Address PO Box
Street 1 90 N 1100 E
Street 2
City Zionsville
State ("NA" if non-U.S. address) IN
Zip/Postal Code 46077
Country (if non-U.S. address) United States
Listing Type

Other Interest Holder

Positional Interests
(check all that apply)

Member of Governing Board (or other governing entity)
Principal Profession or Occupation Professional
By Whom Appointed or Elected Board of Directors
Citizenship, Gender, Ethnicity, and Race Information (Natural Persons Only)
Citizenship US
Gender

Female

Ethnicity

Not Hispanic or Latino

Race White
Interest Percentages
(enter percentage values from 0.0 to 100.0)
Voting 8.3%
Equity 0.0%
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

(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

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(c) 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

3. Organizational Chart (Licensees Only)

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Attach a flowchart or similar document showing the Licensee’s vertical ownership structure including the Licensee and all entities that have attributable interests in the Licensee. Licensees with a single parent entity may provide a brief explanatory textual Exhibit in lieu of a flowchart or similar document. Licensees without parent entities should so indicate in a textual Exhibit.


Non-Licensee Respondents should select “N/A” in response to this question.


License has no parent entity.


Section III - Certification

Certification

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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: Chairman

Exact Legal Title or Name of Respondent: Inter Mirifica, Inc.

Name: Robert Teipen

Phone: 3178708400


12/01/2021