SEC 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
|Estimated average burden|
|hours per response:
1. Name and Address of Reporting Person*
2. Date of Event Requiring Statement
3. Issuer Name and Ticker or Trading Symbol
WEST PHARMACEUTICAL SERVICES INC
[ WST ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
Sr VP, CFO & Treasurer
5. If Amendment, Date of Original Filed
6. Individual or Joint/Group Filing (Check Applicable Line)
||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.
Amount of Securities Beneficially Owned (Instr.
||3. Ownership Form: Direct (D) or Indirect (I) (Instr.
||4. Nature of Indirect Beneficial Ownership (Instr.
Table II - Derivative Securities Beneficially Owned|
(e.g., puts, calls, warrants, options, convertible securities)
|1. Title of Derivative Security (Instr.
||2. Date Exercisable and Expiration Date
||3. Title and Amount of Securities Underlying Derivative Security (Instr.
||4. Conversion or Exercise Price of Derivative Security
||5. Ownership Form: Direct (D) or Indirect (I) (Instr.
||6. Nature of Indirect Beneficial Ownership (Instr.
||Amount or Number of Shares
|Explanation of Responses:|
|No securities are beneficially owned.|
||Ryan Metz as Agent for Bernard Birkett
||** Signature of Reporting Person
|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,
|** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
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,
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
WEST PHARMACEUTICAL SERVICES, INC.
SECTION 16(a) FILINGS
Know all by these presents that the undersigned hereby constitutes and
appoints each of Luis Cantarero, Jeffrey Tse, Ryan Metz and
Joanne Boyle, signing singly, the undersigneds true and lawful
(1) Execute for and on behalf of the undersigned, in the undersigneds
capacity as an officer, director and/or shareholder of West Pharmaceutical
Services, Inc. (the Company), Forms 3, 4, and 5 and amendments thereto
in accordance with Section 16(a) of the Securities Exchange Act of 1934 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 form 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
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-facts 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 undersigneds responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934.
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 undersigneds holdings of and transaction in securities of the 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 of the authority granted herein.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 21st day of June, 2018.
/s/ Bernard Birkett