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)
| PALM BEACH GARDENS |
FL |
33418 |
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2. Date of Event Requiring Statement
(Month/Day/Year)
01/15/2023
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3. Issuer Name and Ticker or Trading Symbol
CARRIER GLOBAL Corp
[ CARR ]
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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)
|
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: |
|
| No securities are beneficially owned. |
|
/s/ William Langston as Attorney-in-Fact |
01/15/2023 |
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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 Kevin J. O'Connor, Mark G. Thompson, and William Langston signing
individually, with full power of substitution and re-substitution, as the
undersigned's true and lawful attorney-in-fact to:
1. Prepare and execute, in the undersigned's name and on the undersigned's
behalf, and submit to the U.S. Securities and Exchange Commission ("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 ("Exchange Act"), as amended, or any rule or
regulation of the SEC;
2. Execute, for and on behalf of the undersigned, Forms 3, 4, and 5 (and any
replacement form or successor to such forms, as may be established by the SEC
from time to time) required to be filed by the undersigned in accordance with
Section 16(a) of the Exchange Act, and file the same with the SEC;
3. Execute, for and on behalf of the undersigned, any Form 144 (and any
replacement form or successor to such form, as may be established by the SEC
from time to time) required to be filed by undersigned in accordance with Rule
144 under the Securities Act of 1933 (the "Securities Act"), as amended, and
file the same with the SEC;
4. Do and perform any and all acts for and on behalf of the undersigned which
may be necessary or desirable to complete and execute any of the documents
referenced in paragraphs 1-3 above, complete and execute any amendments thereto
and timely file such form with the SEC and any stock exchange or similar
authority; and
5. Take any other action of any type whatsoever in connection with the foregoing
(including but not limited to the execution of any written representations
required on behalf of the undersigned to confirm compliance with Rule 144)
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, 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 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 Carrier Global Corporation assuming, any of the undersigned's
responsibilities to comply with Section 16 of the Exchange Act, Rule 144 under
the Securities Act or any other provision of the securities laws.
This Power of Attorney shall remain in effect until the undersigned is no longer
required to file any of the documents referred to above with respect to the
undersigned's holdings of and transactions in securities issued by Carrier
Global Corporation, unless earlier revoked by the undersigned in a signed
writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has hereunto signed this Power of Attorney
this ____ day of ______ 2022.
_________________________________
Susan N. Story
_________________________________
/s/ Susan N. Story
