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*
| 201 ISABELLA STREET |
| SUITE 200 |
(Street)
| PITTSBURGH, |
PA |
15212-5872 |
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2. Date of Event Requiring Statement
(Month/Day/Year)
02/13/2020
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3. Issuer Name and Ticker or Trading Symbol
Arconic Inc.
[ ARNC WI ]
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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) |
| EVP and CFO |
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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)
|
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, par value $0.01 per share |
0 |
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 |
| Explanation of Responses: |
| Remarks: |
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/s/ Margaret Lam (Assistant Secretary, by power of attorney |
02/13/2020 |
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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 PERSONS BY THESE PRESENTS that the undersigned hereby names, constitutes and
appoints the Secretary and each Assistant Secretary of ARCONIC INC., a Delaware corporation (the
Company), or any of them, the undersigned's true and lawful attorney-in-fact and agent to:
(1) prepare, sign for and on behalf of the undersigned, and submit to the U.S. Securities and
Exchange Commission (the 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 by Section 16(a) of the Securities Exchange Act of 1934 or any rule
or regulation of the SEC;
(2) prepare, and sign for and on behalf of the undersigned, as to any equity securities of the
Company, Forms 3, 4 and/or 5, including amendments thereto, in accordance with Section 16(a) of the
Securities Exchange Act of 1934 and the rules thereunder;
(3) timely file any such Forms 3, 4 and/or 5, including amendments thereto, with the SEC and
any stock exchange or similar authority and deliver a copy thereof to the Company in care of the
Secretary; and
(4) take any other action 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 hereby grants to each of such attorneys-in-fact full power and authority to do and
perform any 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, hereby ratifying and confirming all that such attorneys-in-fact 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, in serving in such capacity at the request of
the undersigned, are 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 with respect to the undersigned's holdings of and transactions in equity
securities of the Company, unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. This Power of Attorney shall be governed by and construed in accordance
with the laws of the State of Delaware. The execution of this Power of Attorney is not intended to, and
does not, revoke any prior powers of attorney.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed on
the date set opposite the signature below.
/s/ Erick R. Asmussen February 12, 2020
Signature Date
Erick R. Asmussen
Print Name
