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*
| C/O CHANCERY HOUSE, 190 WATERSIDE ROAD |
| HAMILTON INDUSTRIAL PARK |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
11/02/2015
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3. Issuer Name and Ticker or Trading Symbol
Steris plc
[ STE ]
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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)
|
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: |
| Remarks: |
|
| No securities are beneficially owned. |
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/s/ Dennis P. Patton, Authorized Representative under Power of Attorney |
11/02/2015 |
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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. |
Securities and Exchange Commission Washington, D.C. 20549
RE: STERIS plc
Commission File No.001-37614
1933 Act and 1934 Act Filings
Authorized Representatives
Gentlemen:
The above Company is or will be the issuer of securities registered under
Section 12 of the Securities Exchange Act of 1934. The undersigned 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, Form ID (if
necessary) or otherwise, collectively, "Forms") with respect to securities of
the Company (the "Securities"), and to submit to the Securities and Exchange
Commission such Forms (including reports, notices, and other statements) with
respect to the Securities, as are required by the Securities Act of 1933, as
amended, or the Securities Exchange Act of 1934 as amended (collectively, the
"Acts"). The undersigned 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 undersigned with the filing requirements of the Acts.
This authority revokes all prior authorities with respect to the Securities
previously executed by the undersigned including but not limited to any such
authorities filed with or given to the Commission by the undersigned. This
authority contained herein shall remain in full force and effect until the
undersigned is no longer required to file Forms with respect to the
undersigned's holdings of and transactions in the Securities, unless earlier
revoked by the undersigned in a signed writing delivered to the Authorized
Representatives.
Authorized Representatives
Judith A. Hunter
Julia Kipnis
Rebecca A. Nichols
Dennis P. Patton
Ronald E. Snyder
Michael J. Tokich
J. Adam Zangerle
The undersigned acknowledges that the foregoing Authorized Representatives, in
serving in such capacity at the request of the undersigned, are not assuming,
nor is the Company assuming, any of the undersigned's responsibilities to comply
with the Acts. Additionally, although pursuant to this authority, the
Authorized Representatives will use commercially reasonable best efforts to
timely and accurately file the required Forms on behalf of the undersigned, the
Authorized Representatives do not represent or warrant that they will be able to
in all cases timely and accurately file such Forms on behalf of the undersigned
due to various factors and the undersigned and the Authorized Representatives'
need to rely on others for information, including the undersigned and brokers of
the undersigned.
Dated: October 28, 2015 By: /s/ Jacqueline B. Kosecoff, Ph. D.
Signature
Jacqueline B. Kosecoff, Ph. D.
Printed Name
