Federal Communications Commission
Washington, D.C. 20554
Approved by OMB
3060-0010 (June 2014)
FOR FCC USE ONLY
 

FCC 323
OWNERSHIP REPORT FOR COMMERCIAL BROADCAST STATIONS

FOR COMMISSION USE ONLY
FILE NO. BOS-20160401APU

Section I - General Information
1. Legal Name of the Respondent
ATLANTIC AMERICAN CORPORATION
Street Address (1)
4370 PEACHTREE ROAD, NE
Street Address (2)
City
ATLANTA
State or Country (if foreign address)
GA

ZIP Code
30319 -

Telephone Number (include area code)
4042665500
E-Mail Address (if available) 
FCC Registration Number:
0025100025
Call Sign 
KABY-TV
Facility ID Number 
48659
2. Contact Representative
JOAN STEWART, ESQ.
Firm or Company Name
WILEY REIN LLP
Street Address (1)
1776 K STREET NW
Street Address (2)
City
WASHINGTON
State or Country (if foreign address)
DC
ZIP Code
20006 -
Telephone Number (include area code)
2027197438
E-Mail Address (if available)
JSTEWART@WILEYREIN.COM
3. Nature of Respondent (See Instructions for definitions)
radio button not selected Licensee
radio button not selected Permittee
radio button selected Entity with an attributable interest
4. If this application has been submitted without a fee, indicate reason for fee exemption (see 47 C.F.R. Section 1.1114):
radio button not selectedGovernmental Entity radio button selected radio button not selectedOther Other radio button not selected N/A (Fee Required)
5. All of the information furnished in this Report is accurate as of 02/16/2016
(Date entered must (1) be Oct. 1 of the filing year when filing a Biennial Ownership Report (or Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)
6. Purpose: This Report is filed for: (choose one)
a. radio button not selected Biennial
b. radio button not selected Validation and Resubmission of a previously filed Biennial Report (certifying no change from previous Report)
c. radio button selected Transfer of Control or Assignment of License/Permit
d. radio button not selected Report by Permittee filing within 30 days after the grant of a construction permit for a new commercial AM, FM or full power television broadcast station.
e. radio button not selected Update / certification of accuracy of an initial Ownership Report filed by Permittee (filing in conjunction with Permittee's application for a station license)
f. radio button not selected Amendment to a previously filed Ownership Report
File Number: -
If an Amendment, submit as an Exhibit a listing by Section and Question Number the portions of the previous Report that are being revised.
7. Licensee and Station Information. The stations listed below are all licensed to the following person or entity:
Licensee Name Licensee's FCC Registration Number (FRN)
GRAY TELEVISION LICENSEE, LLC
0018223693
FRN Help: CORES Home

Station List

This Report is filed for the following stations:
Copy Call Sign Facility ID Number Location (City/State) Class of service Delete Copy
1. , TEXAS Television
2. , NEBRASKA Television
3. , COLORADO Television
4. , COLORADO Television
5. , NEBRASKA Television
6. , NEVADA Television
7. , TEXAS Television
8. , TEXAS Television
9. , KENTUCKY Television
10. , VIRGINIA Television
11. , GEORGIA Television
12. , WISCONSIN Television
13. , VIRGINIA Television
14. , KANSAS Television
15. , TENNESSEE Television
16. , KENTUCKY Television
17. , VIRGINIA Class A TV
18. , VIRGINIA TV Translator or LPTV station
19. , ILLINOIS Television
20. , MICHIGAN Television
21. , NORTH CAROLINA Television
22. , FLORIDA Television
23. , KENTUCKY Television
24. , WISCONSIN Television
25. , INDIANA Television
26. , NEBRASKA Television
27. , GEORGIA Television
28. , WISCONSIN Television
29. , WEST VIRGINIA Television
30. , GEORGIA Television
31. , WEST VIRGINIA Television
32. , MISSISSIPPI Television
33. , ALABAMA Television
34. , VIRGINIA Class A TV
35. , NEBRASKA Television
36. , WEST VIRGINIA TV Translator or LPTV station
37. , WEST VIRGINIA TV Translator or LPTV station
38. , FLORIDA TV Translator or LPTV station
39. , ALABAMA TV Translator or LPTV station
40. , NEBRASKA TV Translator or LPTV station
41. , TEXAS TV Translator or LPTV station
42. , COLORADO TV Translator or LPTV station
43. , NEBRASKA TV Translator or LPTV station
44. , NEBRASKA TV Translator or LPTV station
45. , NEBRASKA TV Translator or LPTV station
46. , NEBRASKA TV Translator or LPTV station
47. , NEBRASKA TV Translator or LPTV station
48. , COLORADO TV Translator or LPTV station
49. , NEBRASKA TV Translator or LPTV station
50. , NEBRASKA TV Translator or LPTV station
51. , WEST VIRGINIA TV Translator or LPTV station
52. , OHIO Television
53. , SOUTH DAKOTA Television
54. , SOUTH DAKOTA Television
55. , NORTH DAKOTA Television
56. , NORTH DAKOTA Television
57. , NORTH DAKOTA Television
58. , NORTH DAKOTA Television
59. , SOUTH DAKOTA Television
60. , SOUTH DAKOTA Television
61. , SOUTH DAKOTA Television
62. , NORTH DAKOTA Television
63. , LOUISIANA Television
64. , LOUISIANA Television
65. , NEBRASKA Television
66. , NORTH DAKOTA TV Translator or LPTV station
67. , NEBRASKA TV Translator or LPTV station
68. , TEXAS Television
69. , IDAHO Television
70. , IDAHO TV Translator or LPTV station
71. , MAINE Television
72. , COLORADO TV Translator or LPTV station
73. , SOUTH DAKOTA TV Translator or LPTV station
74. , COLORADO TV Translator or LPTV station
75. , COLORADO TV Translator or LPTV station
76. , TEXAS TV Translator or LPTV station
77. , NEBRASKA Class A TV
78. , WYOMING Television
79. , WYOMING Television
80. , TEXAS Television
81. , WYOMING Television
82. , WYOMING TV Translator or LPTV station
83. , WYOMING TV Translator or LPTV station
84. , WYOMING TV Translator or LPTV station
85. , WYOMING TV Translator or LPTV station
86. , MONTANA Television
87. , MONTANA TV Translator or LPTV station
88. , NORTH DAKOTA TV Translator or LPTV station
89. , MICHIGAN Television
90. , OHIO Television
91. , ARKANSAS TV Translator or LPTV station
92. , GEORGIA Class A TV
93. , KANSAS Television
94. , KANSAS Television
95. , KANSAS Television
96. , KANSAS Television
97. , KANSAS Television
98. , VIRGINIA Television
99. , MISSOURI Television
100. , MISSOURI TV Translator or LPTV station
101. , ALASKA Television
102. , NEBRASKA Television
103. , WYOMING Television
104. , NEBRASKA TV Translator or LPTV station
105. , WYOMING Class A TV
106. , TENNESSEE Television
107. , MICHIGAN Television
108. , MICHIGAN TV Translator or LPTV station
109. , GEORGIA Television

(Check/Uncheck All)
 
8. Respondent is:
radio button not selected Sole Proprietorship radio button not selected Not-for-profit corporation radio button not selected Limited partnership
radio button selected For-profit corporation radio button not selected General partnership radio button not selected Other
If "Other," describe nature of the Respondent in an Exhibit.  
 
 

Section II-A - Non-Biennial Ownership Information

1. Contract Information. List all contracts and other instruments required to be filed by 47 C.F.R. Section 73.3613. (Only Licensees, Permittees, or Respondents with a majority interest in or that otherwise exercise de facto control over the subject Licensee or Permittee shall respond. Other Respondents should select "Not Applicable" in response to this question.) If the agreement is a local marketing agreement (LMA) or a joint sales agreement (JSA), or if the agreement is a network affiliation agreement, check the appropriate box; otherwise, select "Other" for non-LMA/JSA or network affiliation agreements.
checkbox checked Not Applicable

Contract Information

   



2. Capitalization (Only Licensees , Permittees, or entities with a majority interest in or that otherwise exercises de facto control over the subject Licensee shall respond.)
checkbox checked Not Applicable

Capitalization Information


(Check/
Uncheck All)
 
3. (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, noninsulated partners, members and other persons or entities with a direct attributable interest in the Respondent. (A "direct" interest is one that is not held through any intervening companies or entities.) In the case of vertical or indirect ownership structures, report only those interests in the Respondent that also represent an attributable interest in the Licensee or Permittee for which the Report is being submitted.

List each person or entity with a direct attributable interest in the Respondent separately. 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 separate reports for persons or entities that do not have an attributable interest in the Licensee or Permittee for which the report is being submitted.

Ownership Interests Information

Copy 1. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button selected Respondent
radio button not selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button not selected Person with attributable interest
radio button selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox not checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox checked Other (please specify):

FCC Registration Number
0025100025
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 2. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
0020014908
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 3. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox checked Officer
checkbox not checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
9990109606
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 4. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
9990109598
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 5. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
9990109614
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 6. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
9990109622
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 7. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
9990109630
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 8. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
0022537922
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  
Copy 9. Name  
Address Street


City/State
, GEORGIA
Postal/ZIP Code
-
Country (if not U.S.)
Listing Type radio button not selected Respondent
radio button selected Other Interest Holder
Relationship to Licensee/Permittee radio button not selected Licensee/Permittee (or Officer/Director of Licensee/Permittee)
radio button selected Person with attributable interest
radio button not selected Entity with attributable interest
Positional Interest
(Check all that apply)

checkbox not checked Officer
checkbox checked Director
checkbox not checked General Partner
checkbox not checked Limited Partner
checkbox not checked LC/LLC/PLLC Member
checkbox not checked Owner
checkbox not checked Stockholder
checkbox not checked Attributable Creditor
checkbox not checked Attributable Investor
checkbox not checked Other (please specify):

FCC Registration Number
0020015335
  Percentage of votes %  
  Percentage of total assets
(equity debt plus)
%  

(Check/
Uncheck All)

  (b.)

Respondent certifies that any equity and financial interests not reported in response to Question 3(a) are non-attributable.


If "No," submit as an Exhibit an explanation.

radio button selectedYes radio button not selectedNo
(c.) Does the Respondent or any person/entity with an attributable interest in the Respondent also hold an attributable interest in any other broadcast station, or in any newspaper entities in the same market, 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 for the applicable type of interest (broadcast or newspaper). 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.


Broadcast Interest Information

Newspaper Interest Information

radio button not selectedYes radio button selectedNo
(d.)

Are any of the individuals listed in response to Question 3(a) married, related as parent-child, or related as siblings?

If "Yes", complete the information describing the relationship.


Familial Relationships

Copy Name Parent/ Child Spouse Siblings Delete Copy
1. radio button not selected radio button selected radio button not selected
2. radio button selected radio button not selected radio button not selected

(Check/Uncheck All)
 

radio button selectedYes radio button not selectedNo
(e.) Is Respondent seeking an attribution exemption for any officer or director with duties unrelated to the Licensee  or Permittee ?

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.

Exemption Information List

 

(Check/
Uncheck All)

radio button not selectedYes radio button selectedNo

SECTION III - CERTIFICATION


I certify that I am AN OFFICER

(Official Title)


of ATLANTIC AMERICAN CORPORATION

(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 the signature below must (1) be no earlier than Oct. 1 of the filing year when filing a Biennial Ownership Report (and no earlier than Nov. 1, 2009 in the case of the initial filing); or (2) be no more than 60 days prior to the date of filing when filing a non-biennial Ownership Report.)

Signature
HILTON H. HOWELL, JR.
Date
04/01/2016
Telephone Number of Respondent (Include area code) 4042665500

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
Attachment 2
Description
Ownership Calculation