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 APPROVAL |
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*
CIMPRESS N.V. |
BUILDING D, XEROX TECHNOLOGY PARK |
(Street)
DUNDALK, COUNTY LOUTH, IRELAND |
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2. Issuer Name and Ticker or Trading Symbol
CIMPRESS N.V.
[ CMPR ]
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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) |
EVP, Chief Financial Officer
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3. Date of Earliest Transaction
(Month/Day/Year) 02/15/2019
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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 |
Ordinary Shares |
02/15/2019 |
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M |
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111
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A |
$0
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818 |
D |
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Ordinary Shares |
02/15/2019 |
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F |
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39 |
D |
$82.01
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779 |
D |
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Ordinary Shares |
02/17/2019 |
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M |
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613
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A |
$0
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1,392 |
D |
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Ordinary Shares |
02/17/2019 |
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F |
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202 |
D |
$0
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1,190 |
D |
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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 |
Restricted Share Units (right to acquire) |
$0.0
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02/15/2019 |
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M |
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111 |
08/15/2016
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08/15/2019 |
Ordinary Shares |
111 |
$0
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222 |
D |
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Restricted Share Units (right to acquire) |
$0.0
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02/17/2019 |
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M |
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613 |
11/17/2016
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11/17/2019 |
Ordinary Shares |
613 |
$0
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1,840 |
D |
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Explanation of Responses: |
Remarks: |
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/s/Kathryn L. Leach, as attorney-in-fact for Sean E. Quinn |
02/19/2019 |
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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. |
CIMPRESS N.V.
LIMITED POWER OF ATTORNEY
FOR SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby makes, constitutes
and appoints each of Matthew Walsh, Kathryn Leach, and Sean E. Quinn
signing singly and each acting individually, as the undersigned's true and
lawful attorney-in-fact with full power and authority as hereinafter
described to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an executive officer and/or director of Cimpress N.V. (the
Company), Form ID and Forms 3, 4, and 5 (including any amendments
thereto) in accordance with Section 16(a) of the United States Securities
Exchange Act of 1934 and the rules thereunder (the Exchange Act);
(2) execute for and on behalf of the undersigned, in the undersigned's
capacity as an executive officer and/or director of the Company such forms
as the Autoriteit Financiele Markten in the Netherlands (AFM) or other
Dutch authorities or laws may require;
(3) do and perform any and all acts for and on behalf of the undersigned
which may be necessary or desirable to prepare, complete and execute any
such Form ID, Form 3, 4, or 5 or AFM form, prepare, complete and
execute any amendment or amendments thereto, and timely deliver and file
such form with the United States Securities and Exchange Commission,
AFM, and any stock exchange or similar authority;
(4) seek or obtain, as the undersigned's representative and on the
undersigned's behalf, information regarding transactions in the Company's
securities from any third party, including brokers, employee benefit plan
administrators and trustees, and the undersigned hereby authorizes any
such person to release any such information to such attorney-in-fact and
approves and ratifies any such release of information; and
(5) 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 such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of the rights
and powers herein granted, as fully to all intents and purposes as the
undersigned 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 such attorney-in-fact's 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 nor relieving, nor is the Company assuming
nor relieving, any of the undersigned's responsibilities to comply with
Section 16 of the Exchange Act or applicable Dutch securities laws. The
undersigned acknowledges that neither the Company nor the foregoing
attorneys-in-fact assume (i) any liability for the undersigned's responsibility
to comply with the requirements of the Exchange Act or applicable Dutch
securities laws, (ii) any liability of the undersigned for any failure to
comply with such requirements, or (iii) any obligation or liability of the
undersigned for profit disgorgement under Section 16(b) of the Exchange
Act or Dutch securities laws.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, and 5 or AFM forms
with respect to the undersigned's holdings of and transactions in securities
issued by the Company, unless earlier revoked by the undersigned in a
signed writing delivered to the foregoing attorneys-in-fact. This Power of
Attorney supersedes and revokes all previously signed powers of attorney
of the undersigned that grant authority to the Companys personnel with
respect to Form ID, Forms 3, 4 and 5, AFM forms, and other Section 16
and Dutch law compliance matters relating to the Company.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of this 14th day of February, 2019.
/s/Sean Quinn
Signature
Sean Quinn
Print Name