Form 4 HOLOGIC INC For: May 26 Filed by: Valenti Peter J. III
May 28, 2015 4:37 PM EDT
| FORM
4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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: |
3235-0287 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
|
Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue.
See
Instruction 1(b).
|
1. Name and Address of Reporting Person
*
(Street)
|
2. Issuer Name
and
Ticker or Trading Symbol
HOLOGIC INC
[
HOLX
]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| Division Pres., Breast Health |
|
3. Date of Earliest Transaction
(Month/Day/Year)
05/26/2015
|
4. 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 Acquired, Disposed of, or
Beneficially Owned |
|---|
| 1.
Title of Security (Instr.
3)
|
2.
Transaction Date
(Month/Day/Year) |
2A.
Deemed Execution Date, if any
(Month/Day/Year) |
3.
Transaction Code (Instr.
8)
|
4.
Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
|
5.
Amount of Securities Beneficially Owned Following Reported
Transaction(s) (Instr.
3 and 4)
|
6.
Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
7.
Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
Amount |
(A) or (D) |
Price |
|
Common Stock
|
05/26/2015 |
|
M |
|
3,411
|
A
|
$
34.61
|
3,411
|
D
|
|
|
Common Stock
|
05/26/2015 |
|
F |
|
1,153
|
D
|
$
34.61
|
2,258
|
D
|
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
|
5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
|
6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
|
8. Price of Derivative Security (Instr.
5)
|
9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
|
10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
|
11. Nature of Indirect Beneficial Ownership (Instr.
4)
|
| Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
|
Restricted Stock Unit Award (Right To Receive)
|
$
0
|
05/26/2015 |
|
M |
|
|
3,411
|
05/26/2015 |
|
Common Stock
|
3,411
|
$
0
|
10,233
|
D
|
|
| Explanation of Responses: |
|
|
|
/s/ Anne M. Liddy, Attorney-in-fact for Peter J. Valenti, III |
05/27/2015 |
|
** 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. |
SUBSTITUTE POWER OF ATTORNEY
I, Mark J. Casey, the undersigned, by a Power of Attorney dated
April 15, 2014 (the "POA"), was appointed to act as the true
and lawful attorney-in-fact for and on behalf of Peter J.
Valenti, III in his capacity as the Division President - Breast
Health (the "Executive Officer") of Hologic, Inc. (the "Company")
to do and perform any and all acts for and on behalf of the
Executive Officer which may be necessary or desirable to complete
and execute any Forms 3, 4, or 5, complete and execute any
amendment(s) thereto, and timely file such form(s) with the
United States Securities and Exchange Commission and any stock
exchange or similar authority.
As authorized in the POA, I hereby delegate all of the powers contained
therein to each of Robert W. McMahon, Anne M. Liddy and Alisha
Hankins, individually and signing singly, to act as the Executive
Officers?s true and lawful substitute attorney-in-fact.
Further, the undersigned hereby ratifies all acts, deeds and things,
which any substitute attorney-in-fact will lawfully do and execute in
pursuance of the powers granted herein.
This Substitute Power of Attorney shall remain in full force and effect
until revoked by the undersigned, the POA is revoked or the Executive
Officer is no longer required to file Forms 3, 4, and 5 with respect
to the Executive Officer's holdings of and transactions in securities
issued by the Company.
IN WITNESS WHEREOF, the undersigned has caused this Substitute Power
of Attorney to be executed as of this 15th day of December, 2014.
/s/Mark J. Casey
Attorney-in-fact
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