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
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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
| TREASURY BUILDING |
| LOWER GRAND CANAL STREET |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
09/16/2011
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3. Issuer Name and Ticker or Trading Symbol
Alkermes plc.
[ ALKS ]
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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: |
| Remarks: |
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| No securities are beneficially owned. |
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/s/ Jennifer Baptiste, attorney-in-fact for Mark B. Skaletsky |
09/20/2011 |
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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
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. |
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby
revokes all powers ofattorney relating to the following matters
and constitutes and appoints each of James M. Frates, Iain M.
Brown, Jennifer Baptiste, Samuel Parisi, Anne M. Zielinski,
Mitchell S. Bloom and Edward A. King, and any one of them acting
singly, as true and lawful attorneys-in-fact and agents, with
the full power of substitution and resubstitution, for the
undersigned and in the undersigned?s name, place and stead,
in any and all capacities (until revoked in writing) 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 (?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(a) of the Securities Exchange Act of 1934, as amended
(the ?Exchange Act?) or any rules or regulations of the SEC;
(2) prepare, execute, acknowledge, deliver and file for
and on behalf of the undersigned, in the undersigned?s capacity
as an officer and/or director of Alkermes plc, an Irish corporation,
or its subsidiaries (together, the ?Company?), Forms 3, 4,
and 5 (including any amendments thereto) in accordance with
Section 16(a) of the Exchange Act 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 prepare, execute,
acknowledge, deliver and file any such Form 3, 4, or 5, complete and
execute any amendment or amendments thereto, and timely file such
form with the SEC and any stock exchange or similar authority
including, if necessary, non-U.S. regulators;
(4) seek or obtain, as the undersigned's representative and on
the undersigned's behalf, information on transactions in the Company?s
securities from any third party, including without limitation brokers,
employee benefit plan administrators and trustees, and the undersigned
hereby authorizes any such person to release any such information to
the undersigned and approves and ratifies any such release of
information; and
(5) perform any and all other acts which in the discretion of
such attorney-in-fact are necessary or desirable for and on behalf
of the undersigned in connection with the foregoing.
The undersigned acknowledges that: (1) this Power of Attorney
authorizes, but does not require, each such attorney-in-fact to
act in his or her discretion on information provided to such
attorney-in-fact without independent verification of such information;
(2) any documents prepared and/or executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Power of Attorney will
be in such form and will contain such information and disclosure as
such attorney-in-fact, in his or her discretion, deems necessary or
desirable; (3) neither the Company nor such attorneys-in-fact assume
any liability or obligation for the undersigned in connection with
the matters covered hereby, including without limitation (i) any
liability for the undersigned's responsibility to comply with the
requirement of the Exchange Act, (ii) any liability of the undersigned
for any failure to comply with such requirements, or (iii) any obligation
or liability of the undersigned for profit disgorgement under Section
16(b) of the Exchange Act; and (4) this Power of Attorney does not
relieve the undersigned from responsibility for compliance with the
undersigned's obligations under the Exchange Act, including without
limitation the reporting requirements under Section 16 of the
Exchange Act.
The undersigned undertakes and agrees to indemnify the
attorneys-in-fact against all actions, claims, demands, proceedings,
costs, charges, expenses and other liabilities whatsoever which may
be made against the attorneys-in-fact, or for which the
attorneys-in-fact may become liable, by reason of acting pursuant
to this Power of Attorney and the attorneys-in-fact shall not be
liable to the undersigned for any loss or damage occurring as a
result of any act or omission made by the attorneys-in-fact in
good faith by reason of acting pursuant to this Power of Attorney.
The undersigned hereby gives and grants the foregoing
attorneys-in-fact full power and authority to do and perform
all and every act and thing whatsoever requisite, necessary or
appropriate to be done in and about the foregoing matters as
fully to all intents and purposes as the undersigned might or
could do if present, hereby ratifying all that such
attorneys-in-fact of, for and on behalf of the undersigned,
will lawfully do or cause to be done by virtue of this Power of Attorney.
This Power of Attorney will 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 Alkermes plc, unless earlier
revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. This Power of Attorney will be
governed by the laws of the State of New York, without regard
to its choice of law provisions.
IN WITNESS WHEREOF, the undersigned has caused this Power of
Attorney to be executed as of the date set forth below.
Date: September 16, 2011
Signature: /s/Mark Skaletsky
Name: Mark Skaletsky
