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*
| 920 MEMORIAL CITY WAY |
| SUITE 1000 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
01/13/2014
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3. Issuer Name and Ticker or Trading Symbol
FORUM ENERGY TECHNOLOGIES, INC.
[ FET ]
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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) |
|
Other (specify below) |
| EVP & Chief Operating Officer |
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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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| No securities are beneficially owned. |
0 |
D |
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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 |
| Explanation of Responses: |
|
/s/ Prady Iyyanki by John C. Ivascu as Attorney-in-Fact |
01/14/2014 |
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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. |
rrd359785_407628.html
Exhibit 24.1
POWER OF ATTORNEY
For Executing Forms 3, 4 and 5, Form 144 and Schedules 13D and 13G
Known by all these present, that the undersigned hereby constitutes and
appoints each of C. Christopher Gaut, James L. McCulloch and John C. Ivascu, or
either of them signing singly, and with full power of substitution, the
undersigned's true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned (a) Forms 3, 4 and 5
(including amendments thereto) in accordance with Section 16(a) of the
Securities Exchange Act of 1934 and the rules thereunder, (b) Form 144
and (c) Schedules 13D and 13G (including amendments thereto) in
accordance with Sections 13(d) and 13(g) of the Securities Exchange Act
of 1934 and the rules thereunder, but only to the extent each such form
or schedule relates to the undersigned's beneficial ownership of
securities of Forum Energy Technologies, Inc. or any of its subsidiaries;
(2) do and perform any and all acts for and on behalf of the undersigned that
may be necessary or desirable to complete and execute any such
Form 3, 4 or 5, Form 144 or Schedule 13D or 13G (including amendments thereto)
and timely file such Forms or Schedules with the Securities and Exchange
Commission and any stock exchange, self- regulatory association or any other
authority, and provide a copy as required by law or advisable to such persons
as the attorney-in-fact deems appropriate; and
(3) take any other action of any type whatsoever in connection with the
foregoing that, in the opinion of each such attorney-in-fact, may be of
benefit to, in the best interest of, or legally required of the
undersigned, it being understood that the documents executed by the
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 the attorney-in-fact may approve in the attorney-in-fact's discretion.
The undersigned hereby grants to each attorney-in-fact full power and
authority to do and perform all and every act and thing whatsoever requisite,
necessary or proper to be done in the exercise of any of the rights and powers
herein granted, as fully to all intents and purposes as the undersigned might or
could do if personally present, with full power of substitution or revocation,
hereby ratifying and confirming all that the attorney-in-fact, or the attorney-
in-facts substitutes or substitute, 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 attorneys-in-fact, and their
substitutes, in serving in such capacity at the request of the undersigned, are
not assuming (nor is Forum Energy Technologies, Inc. assuming) any of the
undersigned's responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934.
The undersigned agrees that each such attorney-in-fact may
rely entirely on information furnished orally or in writing by or at the
direction of the undersigned to the attorney- in-fact. The undersigned also
agrees to indemnify and hold harmless Forum Energy Technologies, Inc. and each
such attorney-in-fact against any losses, claims, damages or liabilities (or
actions in these respects) that arise out of or are based upon any untrue
statements or omissions of necessary facts in the information provided by or at
the direction of the undersigned, or upon the lack of timeliness in the delivery
of information by or at the direction of the undersigned, to such attorney-in-
fact for purposes of executing, acknowledging, delivering or filing Forms 3, 4
or 5, Form 144 or Schedule 13D or 13G (including amendments thereto) and agrees
to reimburse Forum Energy Technologies, Inc. and such attorney-in-fact on demand
for any legal or other expenses reasonably incurred in connection with
investigating or defending against any such loss, claim, damage, liability or
action.
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, Form 144 and
Schedules 13D and 13G (including amendments thereto) with respect to the
undersigned's holdings of and transactions in securities issued by Forum Energy
Technologies, Inc., unless earlier revoked by the undersigned in a signed
writing delivered to the foregoing attorneys-in-fact. This Power of Attorney
revokes all other powers of attorney that the undersigned has previously granted
concerning the matters described herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of the date written below.
/s/ Prady Iyyanki
-------------------------
Prady Iyyanki
January 13, 2014
