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*
10802 EXECUTIVE CENTER DRIVE |
BENTON BUILDING, SUITE 300 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/20/2021
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3. Issuer Name and Ticker or Trading Symbol
Uniti Group Inc.
[ UNIT ]
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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) |
Interim CFO and PFO |
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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 |
59,304 |
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 |
OP Units
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Common Stock |
98,094 |
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I |
By LLC
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Explanation of Responses: |
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/s/ Paul Bullington |
06/01/2021 |
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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
For Executing Forms 3, 4, and 5
KNOW ALL MEN BY THESE PRESENTS, that the undersigned
hereby constitutes and appoints Daniel Heard, Kenny
Gunderman or Keith Harvey as his true and lawful attorney-
in-fact to:
(1) execute, for and on behalf of the undersigned as
a director or officer of Uniti Group, Inc. and any
successor corporation, any one or more Forms 3, 4, and 5 in
accordance with Section 16(a) of the Securities and
Exchange Act of 1934, as amended, and the rules thereunder;
(2) do and perform any and all acts, for and on
behalf of the undersigned, that may be necessary or
desirable to complete the execution of any such Form 3, 4,
and 5 and the timely filing of such form with the United
States Securities and Exchange Commission and any other
authority; and
(3) take any other action of any type whatsoever in
connection with the foregoing that, 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 discretion.
The undersigned hereby grants to the foregoing attorney-in-
fact full power and authority to do and perform all and
every act and thing whatsoever requisite, necessary, and
proper to be done in the exercise of any of the rights and
powers herein granted, as fully to all intents, and
purposes as such attorney-in-fact might or could do if
personally present, with full power of substitution or
revocation, hereby ratifying and confirming all that such
attorney-in-fact, or his 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 any of the undersigned's
responsibilities to comply with Section 16 of the
Securities Exchange Act of 1934, as amended, or other
applicable securities laws or rules.
IN WITNESS WHEREOF, the undersigned has caused this
Power of Attorney to be executed this as of the 1st day of
June, 2021.
/s/ Paul Bullington
Signature
Paul Bullington
Typed or Printed Name
On the 1st day of June, 2021, before me
personally came Paul Bullington, to me known to be the
person described in and who executed the foregoing
instrument, and acknowledged that he executed the same.
WITNESS my hand and official seal.
/s/ Kathryn Rommel
Signature
Kathryn Rommel
(Printed Name of Notary Public)
[NOTARIAL SEAL]
My commission expires:
1/21/2025
4820-5965-8729.1
4820-5965-8729.1