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
|
| 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*
| C/O MODUSLINK GLOBAL SOLUTIONS INC. |
| 1601 TRAPELO ROAD, SUITE 170 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
10/09/2014
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3. Issuer Name and Ticker or Trading Symbol
ModusLink Global Solutions Inc
[ MLNK ]
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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) |
| SVP & General Counsel |
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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 |
|
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)
|
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)
|
|---|
| 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 |
| Stock Option (right to buy) granted on December 23, 2013 |
|
12/23/2020 |
Common Stock |
6,127 |
5.73 |
D |
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| Explanation of Responses: |
|
|
/s/ Nathaniel Gaede (pursuant to power of attorney) |
10/14/2014 |
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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. |
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MODUSLINK GLOBAL SOLUTIONS, INC.
LIMITED POWER OF ATTORNEY
This statement confirms that the undersigned has authorized and designated each
of Nathaniel Gaede, and Thomas B. Rosedale his attorneys-in-fact to (i) prepare, execute
and file on behalf of the undersigned Form ID or any other necessary documents or forms
in order to obtain access codes (including, without limitation, CIK and CCC codes) for
the undersigned to permit filing on EDGAR, and (ii) prepare, execute and file on behalf
of the undersigned all Forms 3, 4 and 5 (including any amendments thereto) that the
undersigned may be required to file with the U.S. Securities and Exchange Commission
as a result of the undersigned's ownership of or transactions in securities of ModusLink
Global Solutions, Inc. The authority of such attorneys under this Power of Attorney shall
continue until the undersigned is no longer required to file Forms 3, 4 and 5 with regard
to the undersigned's ownership of or transactions in securities of ModusLink Global
Solutions, Inc., unless earlier revoked in writing. The undersigned acknowledges that
such attorneys are not assuming any of the undersigned's responsibilities to comply with
the requirements of Section 16 of the Securities Exchange Act of 1934, as amended, or
any of the undersigned's liabilities for failure to comply with such requirements.
/s/ Alan Cormier
Date: October 7, 2014 __________________________
Name: Alan Cormier
