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
|
OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person*
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 06/01/2023
|
3. Issuer Name and Ticker or Trading Symbol
Fortune Brands Innovations, Inc.
[ FBIN ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
|
Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
|
3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
Common Stock, Par Value $0.01 |
0 |
D |
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
|
/s/ Angela M. Pla, Attorney-in-Fact for Amee Chande |
06/02/2023 |
|
** 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, Amee Chande, hereby constitute and appoint HIRANDA S. DONOGHUE 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
June 1, 2023 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, Amee Chande, executed this Limited Power of Attorney on this
6th day of March, 2023.
/s/ Amee Chande
Amee Chande