Form 3 TrueBlue, Inc. For: May 11 Filed by: Jones Kim Harris
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| 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 |
| Expires: |
December 31, 2014 |
| 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)
05/11/2016
|
3. Issuer Name
and
Ticker or Trading Symbol
TrueBlue, Inc.
[
TBI
]
|
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)
|
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: |
| Ms. Jones holds zero TrueBlue, Inc. securities |
|
/s/ Todd N. Gilman |
05/12/2016 |
|
** 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
1. Designation of Attorneys-in-Fact. The undersigned, hereby
designates each of James E. Defebaugh, Todd N. Gilman, Manal Boulos, and
Kirsty Harlan of K&L Gates LLP, individuals with full power of substitution,
as my attorney-in-fact to act for me and in my name, place and stead, and
on my behalf in connection with the matters set forth in Item 2 below.
2. Powers of Attorney-in-Fact. Each attorney-in-fact, as
fiduciary, shall have the authority to sign all such U.S. Securities and
Exchange Commission SEC reports, forms and other filings, specifically
including but not limited to Forms 3, 4, 5 and 144, as such attorney-in-fact
deems necessary or desirable in connection with the satisfaction of my
reporting obligations under the rules and regulations of the SEC.
3. Effectiveness. This power of attorney shall become
effective upon the execution of this document.
4. Duration. This power of attorney shall remain in effect
until revoked by me. This power of attorney shall not be affected by
disability of the principal.
5. Revocation. This power of attorney may be revoked in
writing at any time by my giving written notice to the attorney-in-fact.
If this power of attorney has been recorded, the written notice of
revocation shall also be recorded.
Date: May 10, 2016.
/s/ Kim Harris Jones____
Kim Harris Jones
STATE OF WASHINGTON )
COUNTY OF PIERCE )
SIGNED OR ATTESTED before me on May 10, 2016, by Kim Harris Jones.
/s/ Teresa Birkeland
Signature of Notary Public
TERESA BIRKELAND
Typed Name of Notary Public
Residing at: Tacoma, Washington
My commission expires: April 1, 2018
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