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 |
|
|
1. Name and Address of Reporting Person*
222 MERCHANDISE MART PLAZA |
|
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year) 05/22/2017
|
3. Issuer Name and Ticker or Trading Symbol
ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
[ MDRX ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
5. If Amendment, Date of Original Filed
(Month/Day/Year)
|
6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
|
Form filed by More than One Reporting Person |
|
Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
|
3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
Common Stock |
0 |
D |
|
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
|
Holly O'Berry by power of attorney for Mara Aspinall |
05/24/2017 |
|
** 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 by these presents that the undersigned hereby constitutes and
appoints each of Eric
Jacobson, Gil Wilson and Holly O'Berry, signing singly, the undersigned's true
and lawful attorney-in-
fact to:
(l) execute for and on behalf of the undersigned, all reports to be filed by the
undersigned
pursuant to Section 16(a) of the Securities Exchange Act of 1934, as amended
(the "Exchange
Act") and the rules promulgated thereunder (including Forms 3, 4, and 5 and any
successor
forms) (the "Section 16 Reports") with respect to the equity securities of
Allscripts Healthcare
Solutions, Inc. (the "Company");
(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 Section 16 Report,
complete and
execute any amendment or amendments thereto, and file such report with the
United States
Securities and Exchange Commission and any stock exchange or similar 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
such attorney-in-fact's discretion.
The powers granted above may be exercised by each such attorney-in-fact on
behalf of the
undersigned, individually, and on behalf of the undersigned in any fiduciary or
representative capacity
in which the undersigned may be acting.
The undersigned hereby grants to each such attorney-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, 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
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
Exchange Act.
This Power of Attorney shall be effective as of the date set forth below
and shall continue in
full force and effect until the undersigned is no longer required to file
Section 16 Reports with respect
to the equity securities of the Company, unless earlier revoked by the
undersigned in a signed writing
delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed
as of this ofMa 2017.
Signature:
Name: Mara G. Aspinall
CHI 2530148v.1