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CommScope Holding (COMM)

Filed: 9 Nov 21, 4:05pm
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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1. Name and Address of Reporting Person*
Lorentzen Kyle David

(Last) (First) (Middle)
C/O COMMSCOPE HOLDING COMPANY, INC.
1,100

(Street)
HICKORY NC 28602

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/01/2021
3. Issuer Name and Ticker or Trading Symbol
CommScope Holding Company, Inc. [ COMM ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & CFO
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 61,900(1) 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
Performance Share Units (2) 12/31/2024 Common Stock 123,800(2) 0.00 D
Explanation of Responses:
1. Reflects restricted stock units that were granted on 01/04/2021 and will vest in equal installments on 01/04/2022, 01/04/2023 and 01/04/2024, subject to the reporting person's continued employment with the issuer.
2. Each performance share unit reflects the right to receive one share of common stock. The performance share units were granted on 01/04/2021 and vest upon the achievement of certain hurdles relating to the issuer's stock price ranging from a low of $15 to a high of $40, and the reporting person's continued employment with the issuer, over the four-year period from 01/04/2021 to 01/04/2025.
Remarks:
/s/Michael D. Coppin, under a Power of Attorney 11/09/2021
** 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 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.