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)
09/10/2012
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3. Issuer Name and Ticker or Trading Symbol
EASTMAN KODAK CO
[ EKDKQ ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| Vice President |
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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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| Common Stock |
30,334 |
D |
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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 |
| Option (right to buy) |
|
10/16/2013 |
Common Stock |
5,000 |
22.82 |
D |
|
| Option (right to buy) |
|
12/11/2013 |
Common Stock |
4,350 |
25.88 |
D |
|
| Option (right to buy) |
|
12/10/2014 |
Common Stock |
47,720 |
23.28 |
D |
|
| Option (right to buy) |
|
01/25/2016 |
Common Stock |
60,810 |
6.96 |
D |
|
| Option (right to buy) |
|
04/13/2016 |
Common Stock |
1,500 |
4.29 |
D |
|
| Restricted Stock Units |
|
|
Common Stock |
113,225 |
|
D |
|
| Restricted Stock Units |
|
|
Common Stock |
28,777 |
|
D |
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| Explanation of Responses: |
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|
|
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| Remarks: |
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|
Susan M. Wylie as attorney-in-fact for Douglas Edwards |
09/20/2012 |
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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
The undersigned, Brad Kruchten, hereby appoints each of Patrick M. Sheller,
Susan M. Wylie
and Jack Bailey, individually, his attorney in fact to:
(1) execute for the undersigned, in the undersigned's capacity as an officer
of Eastman Kodak Company (the "Company"), Forms 3, 4, and 5 in accordance
with Section 16(a) of the Securities Exchange Act of 1934 and the rules
thereunder;
(2) execute for the undersigned, in the undersigned's capacity as an
officer of the Company Form 144 in accordance with the Securities Exchange
Act of 1934 and the rules thereunder;
(3) perform any and all acts for the undersigned which may be necessary
or desirable to complete and execute any such Form 3, 4 or 5, or Form 144
and timely file such form with the United States Securities and Exchange
Commission and any stock exchange or similar authority; 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,
it being understood that the documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Power of Attorney shall be
in such form and shall contain such terms and conditions as such attorney
in fact may approve in his or her discretion.
The undersigned hereby grants to his attorney in fact full power and
authority to do anything that is necessary or desirable in the exercise of
any of the rights and powers herein granted, as fully to all intents and
purposes as the undersigned could do if personally present, with full
power of substitution or revocation, hereby ratifying and confirming all
that such attorney in fact, or such attorney in fact's substitute or
substitutes, shall lawfully do or cause to be done by
virtue of this Power of Attorney and the rights and powers herein granted.
The undersigned acknowledges that the foregoing attorney in fact, in
serving in such capacity at the request of the undersigned, is not
assuming, nor is the Company assuming, any of the undersigned's
responsibilities to comply with Section 16 of the Securities Exchange
Act of 1934.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 and Form 144 with
respect to the undersigned's holdings of and transactions in securities
issued by the Company, unless earlier revoked by the undersigned in a
signed writing to the foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
to be executed as of this 12th day of September, 2012.
/s/Douglas J. Edwards
Sworn to before me this
12th day of September, 2012
Elizabeth R. Shaw
Notary Public
No. 01SH4754599
State of NY, Monroe County
My Commission expires July 31, 2013
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