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56 | I NSIGH T • O c t o b e r 2 0 15 w w w . i n s i g h t o n b u s i n e s s . c o m ENTER CONTEST BY OCTOBER 28! Enter online! Winner will receive a VIP table in the Bud Light Party Pit (good for 4 people), includes Bud Light, soda and popcorn. *Some restrictions apply, see complete details at: www.insightonbusiness.com Win VIP tickets to see Green Bay Gamblers GO ONLINE : CLICK TO REGISTER Register for this free event to introduce the formation of roundtable discussion groups for innovation leaders in the New North region. Agenda includes: • Tour of the Construction Innovation Lab at Miron • Panel of CIO's share ideas on peer-to-peer benefits • Watch a "live" roundtable experience facilitated by John Rogers* Seating is limited. Register today to attend. Call (920) 428-3919 or email brasmussen@insightonbusness.com. Innovation Roundtables operated by the Wisconsin SBDC at UW-Green Bay use the PeerSpectives® protocol created by the Edward Lowe Foundation. *John Rogers is a licensed facilitator for PeerSpectives® Innovation Roundtables A peer-to-peer approach for innovation leaders. Nov. 19th 8-10:30 am Hosted at Miron Construction's new Construction Innovation Lab NOW FORMING Statement of Ownership, Management, and Circulation (Requester Publications Only) 1. Publication Title 2. Publication Number 3. Filing Date 4. Issue Frequency 5. Number of Issues Published Annually 6. Annual Subscription Price (if any) 8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not printer) 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor (Do not leave blank) Publisher (Name and complete mailing address) Editor (Name and complete mailing address) Managing Editor (Name and complete mailing address) 10. Owner (Do not leave blank. If the publication is owned by a corporation, give the name and address of the corporation immediately followed by the names and addresses of all stockholders owning or holding 1 percent or more of the total amount of stock. If not owned by a corporation, give the names and addresses of the individual owners. If owned by a partnership or other unincorporated firm, give its name and address as well as those of each individual owner. If the publication is published by a nonprofit organization, give its name and address.) 11. Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities. If none, check box. PS Form 3526-R, July 2014 [Page 1 of 4 (See instructions page 4)] PSN: 7530-09-000-8855 None 7. Complete Mailing Address of Known Office of Publication (Not printer) (Street, city, county, state, and ZIP+4 ® ) _ Contact Person Telephone (Include area code) Full Name Complete Mailing Address Complete Mailing Address Full Name 12. Tax Status (For completion by nonprofit organizations authorized to mail at nonprofit rates) (Check one) Has Not Changed During Preceding 12 Months Has Changed During Preceding 12 Months (Publisher must submit explanation of change with this statement.) The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes: PRIVACY NOTICE: See our privacy policy on www.usps.com. 0 1 6 0 7 0 9/25/2015 Monthly 12 $60.00 P.O. Box 944 400 n. Richmond Street, Suite B Appleton, WI 54912 Deb Toll 920-882-0491 P. O. Box 944 400 N. Richmond Street, Suite B Appleton, WI 54912 Brian Rasmussen P. O. Box 944 Appleton, WI 54912 Margaret LeBrun P. O. Box 944 Appleton, WI 54912 Sean Johnson P. O. Box 944 Appleton, WI 54912 Insight Publications, LLC P. O. Box 944 Appleton, WI 54912 Brian Rasmussen 2330 Gmeiner Rd. Appleton, WI 54915 Margaret LeBrun 1920 E. Apple Creek Rd. Appleton, WI 54913 PS Form 3526-R, July 2014 (Page 2 of 4) Extent and Nature of Circulation Average No. Copies Each Issue During Preceding 12 Months No. Copies of Single Issue Published Nearest to Filing Date 15. 14. Issue Date for Circulation Data Below 13. Publication Title a. Total Number of Copies (Net press run) In-County Paid/Requested Mail Subscriptions stated on PS Form 3541. (Include direct written request from recipient, telemarketing, and Internet requests from recipient, paid subscriptions including nominal rate subscriptions, employer requests, advertiser's proof copies, and exchange copies.) d. Non- requested Distribution (By mail and outside the mail) b. Legitimate Paid and/or Requested Distribution (By mail and outside the mail) c. Total Paid and/or Requested Circulation (Sum of 15b (1), (2), (3), and (4)) Outside County Paid/Requested Mail Subscriptions stated on PS Form 3541. (Include direct written request from recipient, telemarketing, and Internet requests from recipient, paid subscriptions including nominal rate subscriptions, employer requests, advertiser's proof copies, and exchange copies.) (1) (2) (4) Requested Copies Distributed by Other Mail Classes Through the USPS (e.g., First-Class Mail ® ) Sales Through Dealers and Carriers, Street Vendors, Counter Sales, and Other Paid or Requested Distribution Outside USPS ® (3) Nonrequested Copies Distributed Outside the Mail (Include pickup stands, trade shows, showrooms, and other sources) (4) (1) Outside County Nonrequested Copies Stated on PS Form 3541 (include sample copies, requests over 3 years old, requests induced by a premium, bulk sales and requests including association requests, names obtained from business directories, lists, and other sources) (2) In-County Nonrequested Copies Stated on PS Form 3541 (include sample copies, requests over 3 years old, requests induced by a premium, bulk sales and requests including association requests, names obtained from business directories, lists, and other sources) (3) Nonrequested Copies Distributed Through the USPS by Other Classes of Mail (e.g., First-Class Mail, nonrequestor copies mailed in excess of 10% limit mailed at Standard Mail ® or Package Services rates) Total Distribution (Sum of 15c and e) f. Total Nonrequested Distribution [Sum of 15d (1), (2), (3) and (4)] e. Copies not Distributed (See Instructions to Publishers #4, (page #3)) g. Total (Sum of 15f and g) h. Percent Paid and/or Requested Circulation (15c divided by 15f times 100) i. * If you are claiming electronic copies, go to line 16 on page 3. If you are not claiming electronic copies, skip to line 17 on page 3. Insight October 5, 2015 12,076 12,194 7,015 7,777 7,015 7,777 4,861 4,217 4,861 4,217 11,876 11,994 200 200 12,076 12,194 59 65 Statement of Ownership, Management, and Circulation (Requester Publications Only) 16. Electronic Copy Circulation Average No. Copies Each Issue During Previous 12 Months No. Copies of Single Issue Published Nearest to Filing Date a. Requested and Paid Electronic Copies b. Total Requested and Paid Print Copies (Line 15c) + Requested/Paid Electronic Copies (Line 16a) c. Total Requested Copy Distribution (Line 15f) + Requested/Paid Electronic Copies (Line 16a) d. Percent Paid and/or Requested Circulation (Both Print & Electronic Copies) (16b divided by 16c Í 100) I certify that 50% of all my distributed copies (electronic and print) are legitimate requests or paid copies. 18. Signature and Title of Editor, Publisher, Business Manager, or Owner Date I certify that all information furnished on this form is true and complete. I understand that anyone who furnishes false or misleading information on this form or who omits material or information requested on the form may be subject to criminal sanctions (including fines and imprisonment) and/or civil sanctions (including civil penalties). 17. Publication of Statement of Ownership for a Requester Publication is required and will be printed in the issue of this publication. Insight 768 1,041 7,783 8,818 12,644 13,035 62 68 October, 2015 Insight Co-Publisher Sept. 21, 2015