0000899243-23-004969.txt : 20230214 0000899243-23-004969.hdr.sgml : 20230214 20230214153936 ACCESSION NUMBER: 0000899243-23-004969 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221231 FILED AS OF DATE: 20230214 DATE AS OF CHANGE: 20230214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: EPPERSON STUART W CENTRAL INDEX KEY: 0001190973 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26497 FILM NUMBER: 23628089 MAIL ADDRESS: STREET 1: 3780 WILL SCARLET RD CITY: WINSTON SALEM STATE: NC ZIP: 27104 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SALEM MEDIA GROUP, INC. /DE/ CENTRAL INDEX KEY: 0001050606 STANDARD INDUSTRIAL CLASSIFICATION: RADIO BROADCASTING STATIONS [4832] IRS NUMBER: 770121400 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6400 NORTH BELT LINE ROAD CITY: IRVING STATE: TX ZIP: 75063 BUSINESS PHONE: 8059870400 MAIL ADDRESS: STREET 1: 6400 NORTH BELT LINE ROAD CITY: IRVING STATE: TX ZIP: 75063 FORMER COMPANY: FORMER CONFORMED NAME: SALEM COMMUNICATIONS CORP /DE/ DATE OF NAME CHANGE: 19971201 5 1 doc5.xml FORM 5 SUBMISSION X0306 5 2022-12-31 0 0 0 0001050606 SALEM MEDIA GROUP, INC. /DE/ SALM 0001190973 EPPERSON STUART W 3780 WILL SCARLET RD WINSTON SALEM NC 27104 0 0 1 0 Class B Common Stock 2022-05-03 5 G 0 2776848 0.00 D Class A Common Stock 2776848 0 D Each share of Class B Common Stock is convertible into one of share of Class A Common Stock at any time, at the holder's election and upon the occurrence of other events set forth in the Issuer's Amended and Restated Certificate of Incorporation. On May 3, 2022, Stuart W. Epperson transferred 2,776,848 shares of Class B Common Stock to an irrevocable trust for the benefit of his descendants. Stuart W. Epperson has not retained any voting or dispositive power over such gifted shares. This was a bona fide gift with no payment in consideration. /s/Christopher J. Henderson, Attorney-in-fact for Stuart W. Epperson pursuant to a continuing Power of Attorney 2023-02-14