SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/17/2017
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3. Issuer Name and Ticker or Trading Symbol
HAEMONETICS CORP
[ HAE ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
No securities are beneficially owned. |
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/s/ Alexander P. Steffan, attorney-in-fact for Mr. Abernathy |
10/19/2017 |
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** Signature of Reporting Person |
Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
* If the form is filed by more than one reporting person,
see
Instruction
5
(b)(v). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
POWER OF ATTORNEY
For Executing SEC Securities Transaction Forms
Known all by these present that the undersigned hereby constitutes
and appoints each of, and Alexander Steffan, Kristen Feetham
and Brian Foster signing singly, his/her true and lawful
attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the
undersigned?s capacity as an officer and/or director of
Haemonetics Corporation (the ?Company?),Forms 3, 4 and 5
in accordance with Section 16(a) of the Securities Exchange Act
of 1934 and the rules thereunder and such other forms as may
be required by the SEC relating to transactions by the
undersigned in securities issued by the Company (?Forms?);
(2) do and perform any and all acts for and on behalf
of the undersigned which may be necessary or desirable
to complete the execution of any such Forms,complete
and execute an amendment or amendments thereto, and timely
file such Forms with the United States Securities and
Exchange Commission and any other authority; and
(3) take any other action of any type whatsoever
in connection with the foregoing which, in the
opinion of such attorney-in-fact, may be of benefit
to,in the best interest of, or legally required by,
the undersigned, it being understood that the documents
executed by such attorney-in-fact on behalf of the
undersigned pursuant to this Power of Attorney shall
be in such form and shall contain such terms and
conditions as such attorney-in-fact may approve
in his/her discretion.
The undersigned hereby grants to each such
attorney-in-fact full power and authority to do and
perform all and every act and thing whatsoever requisite,
necessary and proper to be done in the exercise of any
of the rights and powers herein granted, as fully to all
intents and purposes as such attorney-in-fact might or
could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming
all that such attorney-in-fact, or his/her substitute or
substitutes, shall lawfully do or cause to be done
by virtue of this power of attorney and the rights and
powers herein granted. The undersigned acknowledges that
the foregoing attorneys-in-fact, in serving in such
capacity at the request of the undersigned, are not
assuming any of the undersigned?s responsibilities to
comply with Section 16 of the Securities and Exchange
Act of 1934.
This Power of Attorney shall remain in full force and
effect until the undersigned is no longer required
to file the Forms with respect to the undersigned?s holdings
of and transactions in securities issued by the Company, unless
revoked by the undersigned in a signed writing delivered
to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused his/her
Power of Attorney to be executed as of this
18th day of October, 2017.
/s/ Robert E. Abernathy
Signature
Robert E. Abernathy
Print Name