Form 3 HEALTHCARE REALTY TRUST For: May 11 Filed by: Gupta Ajay
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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
*
| 3310 WEST END AVENUE |
| SUITE 700 |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
05/11/2021
|
3. Issuer Name
and
Ticker or Trading Symbol
HEALTHCARE REALTY TRUST INC
[
HR
]
|
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
|
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: |
|
Andrew E. Loope, as power of attorney |
05/12/2021 |
|
** 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. |
LIMITED POWER OF ATTORNEY
The undersigned hereby appoints each of John M. Bryant, Jr., Amanda L. Callaway, and Andrew E. Loope as his attorney-in-fact
with full power to act in his name, place and stead for the limited purpose of executing on his behalf all forms required to
be signed and filed by him under Section 16 of the Securities Exchange Act of 1934 and the rules and regulations promulgated
thereunder. The authority of the foregoing individuals shall continue until the undersigned is no longer required to file any
of the aforementioned forms with regard to the undersigned's ownership of or transactions in securities of Healthcare Realty
Trust Incorporated, unless earlier revoked in writing. The undersigned acknowledges that the foregoing individuals are not
assuming any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934.
IN WITNESS WHEREOF, the undersigned hereunto sets his/her hand this 6th day of April 2021.
____/s/ Ajay Gupta_______________________________
Ajay Gupta
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