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 |
Expires: |
December 31, 2014 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person
*
C/O ALPHABET INC. |
1600 AMPHITHEATRE PKWY |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/24/2016
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3. Issuer Name
and
Ticker or Trading Symbol
Alphabet Inc.
[
GOOG
]
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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)
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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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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: |
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/s/ Valentina Margulis, Attorney-in-Fact for Mr. Roger W. Ferguson, Jr. |
06/28/2016 |
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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. |
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby
constitutes and appoints each of Kent Walker, Christine Flores,
Kenneth Yi, Nancy Walker, and Valentina Margulis
and such other persons as may be designated by the Chief Legal
Officer of Alphabet Inc. (the ?Company?), or any of them signing singly,
and with full power of substitution,
the undersigned?s true and lawful attorney in fact to:
(1) prepare, execute in the undersigned?s name and on the
undersigned?s behalf, and submit to the U.S. Securities and Exchange
Commission (the ?SEC?) a Form ID, including amendments thereto, and
any other documents necessary or appropriate to obtain codes and
passwords enabling the undersigned to make electronic filings with
the SEC of reports required by Section 16 of the Securities Exchange
Act of 1934 or any rule or regulation of the SEC promulgated
thereunder, or any successor laws and/or regulations;
(2) execute for and on behalf of the undersigned, in the
undersigned?s capacity as a director of the Company, Forms 3, 4,
and 5 in accordance with Section 16 of the Securities Exchange Act
of 1934 and the rules thereunder;
(3) 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, or 5, complete and execute any amendment
or amendments thereto, and timely file such form with the SEC, any
stock exchange, any national association, and such other person, agency
or similar authority, as a consequence of the undersigned?s ownership,
acquisition or disposition of securities of the Company; and
(4) 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
hereby ratifies and confirms all that the attorneys-in-fact and their
agents shall do or cause to be done by virtue hereof. 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 of 1934.
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 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.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 22nd day of June 2016.
/s/ Roger W. Ferguson, Jr.
Signature
Roger W. Ferguson, Jr.
Print Name