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*
222 MERCHANDISE MART PLAZA |
SUITE 2024 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/22/2020
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3. Issuer Name and Ticker or Trading Symbol
ALLSCRIPTS HEALTHCARE SOLUTIONS, INC.
[ MDRX ]
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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) |
SVP Gerneral 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 |
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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 |
189,346 |
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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Holly Teague by power of attorney for Tejal Vakharia |
06/24/2020 |
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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 by these presents that the undersigned hereby constitutes
and appoints each of Eric Jacobson, Holly Teague and Nick Bradley,
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 of June 18, 2020.
Signature: /s/
Name: Tejal Vakharia