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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/07/2023
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3. Issuer Name and Ticker or Trading Symbol
VIASAT INC
[ VSAT ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
President, Maritime |
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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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$.0001 par value common stock |
17,581 |
I
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By Ogier Global Trustee (Jersey), Limited |
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 |
restricted stock units |
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common stock |
20,000 |
0.00 |
D |
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Explanation of Responses: |
Remarks: |
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Kathleen K. Hollenbeck, Attorney-in-Fact |
09/15/2023 |
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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 by these presents, that the undersigned hereby makes, constitutes and
appoints each of Kathleen K. Hollenbeck, Stacy Nguyen, Barbara Olson, Brett
Church and Paul Castor, or any of them acting singly, and with full power of
substitution and re-substitution, as the undersigned's true and lawful
attorney-in-fact (each of such persons and their substitutes being referred to
herein as the "Attorney-in-Fact"), with full power and authority as hereinafter
described on behalf of and in the name, place and stead of the undersigned to:
1) prepare, execute, and submit to the 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 or considered by the
Attorney-in-Fact to be advisable under Section 13 or Section 16 of the
Securities Exchange Act of 1934 (the "Exchange Act") or any rule or regulation
of the SEC;
2) prepare, execute, acknowledge, deliver, file and submit to the SEC, Viasat,
Inc., a Delaware corporation (the "Company"), and any national securities
exchange on which the Company's securities are listed, any and all reports
(including any amendments thereto) the undersigned is required to file with the
SEC under Section 13 or Section 16 of the Exchange Act or any rule or regulation
promulgated thereunder or under Rule 144 under the Securities Act of 1933 ("Rule
144"), with respect to any security of the Company, including Forms 3, 4 and 5,
Schedules 13D and 13G, and Forms 144;
3) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information regarding transactions in the Company's securities from any
third party, including the Company and any brokers, dealers, employee benefit
plan administrators and trustees, and the undersigned hereby authorizes any such
third party to release any such information to the Attorney-in-Fact; and
4) take any other action of any type whatsoever in connection with the foregoing
which, in the opinion of such Attorney-in-Fact, may be of benefit to, in the
best interest of, or legally required by, the undersigned.
The undersigned acknowledges that:
1) this Power of Attorney authorizes, but does not require, the 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 the Attorney-in-Fact on behalf of
the undersigned pursuant to this Power of Attorney will be in such form and will
contain such terms and conditions and such information and disclosure as the
Attorney-in-Fact, in his or her discretion, deems necessary or desirable;
3) neither the Company nor the Attorney-in-Fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirements of Section 16
of the Exchange Act or Rule 144, (ii) any liability of the undersigned for any
failure to comply with such requirements, or (iii) any liability of the
undersigned for disgorgement of profits 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 Section 16 of the
Exchange Act, including, without limitation, the reporting requirements under
Section 16 of the Exchange Act.
The undersigned hereby gives and grants to each such Attorney-in-Fact
full power and authority to do and perform each and every act and thing
whatsoever requisite, necessary or advisable to be done in the exercise of any
of the rights and powers herein granted or otherwise in connection with the
foregoing, as fully, to all intents and purposes as the undersigned might or
could do in person, with full power of substitution and resubstitution or
revocation, hereby ratifying and confirming all that the Attorney-in-Fact, or
his or her substitute or substitutes, shall lawfully do or cause to be done by
authority of this Power of Attorney and the rights and powers herein granted.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 4 or 5 or Schedules 13D or 13G
or Forms 144 with respect to the undersigned's holdings of and transactions in
securities of the Company, unless earlier revoked by the undersigned in a signed
writing delivered to the foregoing Attorneys-in-Fact or by the undersigned's
execution and delivery to the Company of a new power of attorney with respect to
the subject matter of this Power of Attorney. This Power of Attorney revokes all
previous powers of attorney with respect to the subject matter of this Power of
Attorney.
IN WITNESS WHEREOF, the undersigned has executed this Power of Attorney as of
this 6 day of September, 2023.
/s/ Benjamin Edward Palmer
Name: Benjamin Edward Palmer