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*
| CONNAUGHT HOUSE |
| 1 BURLINGTON ROAD |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
11/18/2021
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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 |
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| 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/ Stephanie Roche, attorney-in-fact for Cato T. Laurencin |
11/24/2021 |
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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. |
EXHIBIT 24.1
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby revokes all powers of
attorney relating to the following matters and constitutes and appoints each of
Iain M. Brown, Samuel Parisi, Shantale Greenson, Christopher Ciulla, Stephanie
Roche, Rob Puopolo, Amy Pomerleau and Tracy Rockwell, 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 requirements 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: 11/24/21
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Signed: /s/ Cato T. Laurencin
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Name: Cato T. Laurencin
