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) 11/18/2019
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3. Issuer Name and Ticker or Trading Symbol
Fortune Brands Home & Security, Inc.
[ FBHS ]
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4. 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) |
President Cabinets |
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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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Common Stock, Par Value $0.01 |
0 |
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 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: |
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/s/ Angela M. Pla, Attorney-in-Fact for R. David Banyard |
11/18/2019 |
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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
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. |
LIMITED POWER OF ATTORNEY
I, R. David Banyard, Jr. hereby constitute and
appoint ROBERT K. BIGGART and ANGELA M. PLA, with
full powers of substitution or revocation, to
serve as my Attorneys-In-Fact and Agents to
exercise the powers and discretions set forth
below:
1. To execute on my behalf any and all
Securities and Exchange Commission ("SEC")
(i) Forms 3, 4 and 5 in accordance with Section 16
of the Securities Exchange Act of 1934, as amended
(the "Exchange Act"), and the rules thereunder,
relating to the disclosure of my beneficial
ownership of securities in Fortune Brands Home &
Security, Inc. (the "Company") and (ii) Forms 144
in accordance with the Securities Act of 1933, as
amended (the "Securities Act"), and the rules
thereunder, relating to my transactions in the
securities of the Company; and
2. Do and perform any and all acts for and on
behalf of the undersigned which may be necessary
or desirable to complete and execute any such Form
3, 4, 5 or Form 144 and timely file such form with
the SEC and any stock exchange or similar
authority and take any other action of any type
whatsoever in connection with the foregoing which,
in the opinion of such attorneys-in-fact, may be
of benefit to, in the best interest of, or legally
required by, the undersigned.
The undersigned hereby grants to each such
attorneys-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 attorneys-in-fact 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 is the Company assuming, any of the
undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act or Rule
144 of the Securities Act.
This Power of Attorney shall at all times be
binding with respect to all actions taken by the
attorneys-in-fact in accordance with the terms of
this Power of Attorney. The powers granted by this
Power of Attorney shall begin on November 18, 2019
and shall continue in full force and effect until
the undersigned is no longer required to file
Section 16 Reports with respect to the equity
securities of the Company, unless earlier revoked
by the undersigned in a signed writing delivered
to the foregoing attorneys-in-fact.
I, R. David Banyard, Jr. executed this Limited
Power of Attorney on this 30th day of October,
2019.
/s/ R. David Banyard, Jr.
R. David Banyard, Jr.