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
PC TEL INC
[ PCTI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
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.|
||by Paul K Griffin - Atty-in-Fact
||** 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
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents that the undersigned hereby makes, constitutes and
appoints each of John Schoen, Les Sgnilek, Michelle Henry and Paul Griffin of
PCTEL, Inc., (the "Corporation") as the undersigned's true and lawful
attorney(s)-in-fact and agents, with full power and authority, on behalf of and
in the name, place and stead of the undersigned to complete and execute such
Forms 144, Forms 3, 4 and 5, and such other forms as such attorney(s)-in-fact
and agents shall in his/her discretion determine to be required or advisable
pursuant to Rule 144 promulgated under the Securities Act of 1933 (as amended),
Section 16 of the Securities Exchange Act of 1934 (as amended) and the rules and
regulations promulgated thereunder, or any successor laws and regulations,
(collectively, the "Exchange Act") as a consequence of the undersigned's
ownership, acquisition or disposition of securities of the Corporation, and to
do all acts necessary in order to file such Forms with the Securities and
Exchange Commission, any securities exchange or national association, the
Corporation and such other person or agency as the attorney(s)-in-fact and
agents shall deem appropriate.
The undersigned hereby ratifies and confirms all
that said attorney(s)-in-fact and agent(s) shall do or cause to be done by
This Limited Power of Attorney does not relieve the undersigned from
responsibility for compliance with the undersigned's obligations under the
Exchange Act, including without limitation the reporting requirements under
Section 16 of the Exchange Act.
This Limited 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 issued by the
Corporation, unless earlier revoked by the undersigned in a signed writing
delivered to such attorney(s)-in-fact and agent(s).
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to
be executed as of this __13th______ day of ____February_, 2018____.
_____/s/ Cynthia A. Keith___________
____ Cynthia A. Keith________________
State of __Texas_____
County of __Dallas_____
On this _13th____ day of __February____, 2018_____, ___ Cynthia A. Keith_______
personally appeared before me and acknowledged that he executed the foregoing
instrument for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
__/s/ Nelly Mata__________
My Commission Expires SEAL