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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
02/04/2019
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3. Issuer Name and Ticker or Trading Symbol
PAPA JOHNS INTERNATIONAL INC
[ PZZA ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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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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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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| No securities are beneficially owned. |
|
Debra Tate Johnson, by Power of Attorney |
02/06/2019 |
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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. |
LIMITED POWER OF ATTORNEY
For Executing SEC Forms ID, 3, 4, 5 and 144
The undersigned hereby constitutes and appoints Clara M. Passafiume, Kenneth M.
Cox and Debra Tate Johnson, and each of them signing individually, his or her
true and lawful attorney-in-fact to:
1. Execute for and on behalf of the undersigned Form ID, Uniform Application for
Access Codes to File on EDGAR, any other forms or applications to change or
obtain new EDGAR access codes or passwords, and Forms 3, 4 and 5 Statements of
Beneficial Ownership of Securities in accordance with Section 16(a) of the
Securities Exchange Act of 1934 and the rules promulgated thereunder, regarding
my ownership of and transactions in securities issued by Papa John's
International, Inc. (the "Company"), and any amendments thereto;
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 Forms ID, 3,
4, 5 and 144 and the timely filing of such application, notice or form with the
Securities and Exchange Commission, NASDAQ and any other 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 Limited Power of Attorney shall be in such form and
shall contain such terms and conditions as such attorney-in-fact may approve
in his or her discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform each 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 or her 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. This
Limited Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, 5 or 144 with respect to
the undersigned's holdings of and transactions in securities issued by the
Company, unless earlier revoked by the undersigned in a signed writing delivered
to the foregoing attorneys-in-fact. The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming any of the undersigned's responsibilities to
comply with any applicable securities laws, rules or regulations, including but
not limited to Section 16 of the Securities Exchange Act of 1934 and Rule 144 of
the Securities Act of 1933 and rules and regulations promulgated thereunder.
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to
be executed as of this 5th day of February, 2019.
__/s/ Anthony M. Sanfilippo_________________
Anthony M. Sanfilippo
