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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1. Name and Address of Reporting Person*
Croatti Michael A

(Last) (First) (Middle)
68 JONSPIN ROAD

(Street)
WILMINGTON MA 01887

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/26/2015
3. Issuer Name and Ticker or Trading Symbol
UNIFIRST CORP [ UNF ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Senior VP of Operations
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 1,309 D
Class B Common Stock 48,292 D
Common Stock 810 I By 401(k) Plan
Class B Common Stock 2,000 I(1) By Son
Class B Common Stock 2,000 I(1) By Son
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
Stock appreciation right 10/26/2015 10/26/2020 Common stock/$0.10 par value 1,000 45.57 D
Stock appreciation right 10/25/2016 10/25/2021 Common stock/$0.10 par value 1,000 49.67 D
Stock appreciation right 10/22/2017 10/22/2022 Common stock/$0.10 par value 8,000 69.05 D
Stock appreciation right 10/28/2018 10/28/2023 Common stock/$0.10 par value 8,000 102.9 D
Stock appreciation right 10/27/2019 10/27/2024 Common stock/$0.10 par value 8,000 106.99 D
Stock appreciation right 10/26/2020 10/26/2025 Common stock/$0.10 par value 4,000 104.67 D
Explanation of Responses:
1. Represents shares owned by Michael Croatti's children. Michael Croatti disclaims beneficial ownership of these reported securities, except to the extent of his pecuniary interest therein, and this report shall not be deemed an admission that he is the beneficial owner of these securities for purposes of Section 16 or any other purpose.
/s/ David Whitman, Attorney-in-Fact 11/03/2015
** 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.
croattipoa.htm

LIMITED POWER OF ATTORNEY FOR

UNIFIRST CORPORATION

SECTION 16(a) FILINGS

 

 

 

Know all by these presents, that the undersigned hereby revokes all previous Powers of Attorney executed by the undersigned with respect to the matters set forth below, and hereby constitutes and appoints each of Ronald D. Croatti, StevenS. Sintros, Shane O'Connor and David Whitman, with full power of substitution, signing singly, the undersigned's true and lawful attorney-in-fact to:

 

 

(I)

execute for and on behalf of the undersigned, in the undersigned's capacity as an officer ofUniFirst Corporation (the "Company''), Forms 3, 4, and 5 and amendments thereto in accordance with Section I6(a) of the Securities Exchange Act of I 934, as amended, and the rules thereunder;

 

 

(2)

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 such Form 3, 4, or 5 or amendment thereto and timely file such forms with the United States Securities and Exchange Commission (the "SEC") and any stock exchange or similar authority; and

 

 

(3)

take any other action of any type whatsoever which, in the opinion of such attorney-in-fact, may be necessary or desirable in connection with the foregoing authority, 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.

 

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 I6 of the Securities Exchange Act of I934, as amended, and the rules thereunder. 

 

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 securities ofthe Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. This Power of Attorney may be filed with the SEC as a confirming statement ofthe authority granted herein.

 

 

IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to be executed as of this __ day of October 2015.

 

 

 

 

/s/ Michael A. Croatti

 

 

 

Michael A. Croatti