Initial Statement of Beneficial Ownership (3)
03 Outubro 2016 - 9:29AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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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1. Name and Address of Reporting Person
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Gorski Jeffrey G
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2. Date of Event Requiring Statement (MM/DD/YYYY)
10/1/2016
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3. Issuer Name
and
Ticker or Trading Symbol
RR Donnelley & Sons Co [RRD]
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(Last)
(First)
(Middle)
C/O R. R. DONNELLEY & SONS COMPANY, 35 WEST WACKER DRIVE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
See Remarks /
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(Street)
CHICAGO, IL 60601
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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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Common Stock
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7
(1)
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D
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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 Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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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 of Derivative Security: 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
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Expiration Date
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Title
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Amount or Number of Shares
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Options to acquire Common Stock
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(2)
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3/2/2022
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Common Stock
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(3)
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(3)
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D
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Explanation of Responses:
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(
1)
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Reflects one for three reverse stock split that was effective on October 1, 2016.
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(
2)
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The options to acquire common stock have vested in whole and are exercisable immediately.
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(
3)
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The number of options over R. R. Donnelley & Sons Company ("RRD") common stock has not yet been determined, as options over RRD common stock outstanding prior to October 1, 2016 will be adjusted (a) to give effect to the reverse stock split described in note 1 above, and (b) to give effect to the distribution by RRD of 80.75% of the common stock of LSC Communications, Inc. ("LSC") and Donnelley Financial Solutions, Inc. ("Donnelley Financial"), which occurred on October 1, 2016 (collectively, the "Spinoffs"). The number of options over RRD common stock will be determined after the date hereof pursuant to, with respect to the Spinoffs, an equitable adjustment in the Separation and Distribution Agreement, dated as of September 14, 2016, by and among RRD, LSC and Donnelley Financial and, with respect to the reverse stock split, pursuant to the RRD 2012 Performance Incentive Plan. The Reporting Person will amend this Form 3 when such information is available.
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Remarks:
Controller and Chief Accounting Officer
Jeffrey G. Gorski became Controller and Chief Accounting Officer of R. R. Donnelley & Sons Company on October 1, 2016. Exhibit Index Exhibit 24 - Power of Attorney
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Gorski Jeffrey G
C/O R. R. DONNELLEY & SONS COMPANY
35 WEST WACKER DRIVE
CHICAGO, IL 60601
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See Remarks
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Signatures
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/s/ Deborah L. Steiner, Deborah L. Steiner, Attorney-In-Fact for Jeffrey G. Gorski
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10/1/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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