SEC FORM
4
SEC Form 4
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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 Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
STERIS CORP
[ STE ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| V. P. - Human Resources |
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3. Date of Earliest Transaction
(Month/Day/Year)
05/30/2013
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4. 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 Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
Amount |
(A) or (D) |
Price |
| Common Shares, No Par Value |
05/30/2013 |
|
F |
|
202
|
D |
$45.87
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4,642 |
D |
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| Common Shares, No Par Value |
05/31/2013 |
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F |
|
112
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D |
$45.34
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4,530 |
D |
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| Common Shares, No Par Value |
05/31/2013 |
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A |
|
4,000 |
A |
$0
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8,530
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D |
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| Common Shares, No Par Value |
|
|
|
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|
|
|
766 |
I |
See Footnote Below.
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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11. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Option to Purchase Common Shares |
$45.34
|
05/31/2013 |
|
A |
|
4,000 |
|
|
05/31/2023 |
Common Shares, No Par Value |
4,000 |
$0
|
4,000 |
D |
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| Explanation of Responses: |
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/s/ Dennis P. Patton, Authorized Representative under Power of Attorney |
06/03/2013 |
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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
4
(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. |
rrd343494_388351.html
Securities and Exchange Commission
Washington, D.C. 20549
RE: STERIS Corporation
Commission File No. 0-20165
1933 Act and 1934 Act Filings
Authorized Representatives
Gentlemen:
The above Company is the issuer of securities registered under Section 12 of the Securities
Exchange Act of 1934. The person signing below confirms, as of the date appearing opposite
his/her signature, that each of the "Authorized Representatives" named below is authorized on
his/her behalf to sign such statements (on Form 3, Form 4, Form 5, Form 144, Schedule 13G, or
otherwise) with respect to securities of the Company (the "Securities"), and to submit to the
Securities and Exchange Commission such filings (including reports, notices, and other statements)
with respect to the Securities, as are required by the Securities Act of 1933 or the Securities
Exchange Act of 1934 (collectively, the "Acts"). The person so signing also confirms the authority
of each of the Authorized Representatives to do and perform, on his/her behalf, any and all acts
and things with respect to the Securities requisite or necessary to assure compliance by the signing
person with the filing requirements of the Acts. The authority confirmed herein shall remain in
effect as to the person signing below until such time as the Commission shall receive from that
person a written communication terminating or modifying the authority.
Authorized Representatives
Mark D. McGinley
Michael J. Tokich
Ronald E. Snyder
Dennis P. Patton
J. Adam Zangerle
Dated: July 27, 2012 By: /s/ Suzanne Forsythe
