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*
CAZALOT CLARENCE P JR

(Last) (First) (Middle)
17021 ALDINE WESTFIELD ROAD

(Street)
HOUSTON TX 77073

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
07/03/2017
3. Issuer Name and Ticker or Trading Symbol
Baker Hughes a GE Co [ BHGE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
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)
Class A Common Stock 39,198 D
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 Option (Right to Buy) 07/03/2017 07/24/2017 Class A Common Stock 303 64.78 D
Stock Option (Right to Buy) 07/03/2017 01/23/2018 Class A Common Stock 357 52.42 D
Stock Option (Right to Buy) 07/03/2017 08/11/2018 Class A Common Stock 323 59.7 D
Stock Option (Right to Buy) 07/03/2017 01/21/2019 Class A Common Stock 1,028 11.68 D
Stock Option (Right to Buy) 07/03/2017 07/22/2019 Class A Common Stock 759 22.02 D
Stock Option (Right to Buy) 07/03/2017 01/19/2020 Class A Common Stock 634 29.78 D
Stock Option (Right to Buy) 07/03/2017 07/21/2020 Class A Common Stock 1,155 31.67 D
Stock Option (Right to Buy) 07/03/2017 01/26/2021 Class A Common Stock 1,077 44.82 D
Stock Option (Right to Buy) 07/03/2017 07/19/2021 Class A Common Stock 871 59.5 D
Stock Option (Right to Buy) 07/03/2017 01/25/2022 Class A Common Stock 1,700 29.94 D
Stock Option (Right to Buy) 07/03/2017 07/16/2022 Class A Common Stock 2,053 21.8 D
Explanation of Responses:
Remarks:
Following the consummation of the transactions contemplated by the Transaction Agreement and Plan of Merger, dated as of October 30, 2016, among General Electric Company, a New York corporation, Baker Hughes Incorporated, a Delaware corporation ("BHI"), the Issuer and certain subsidiaries of BHI, as amended by that certain Amendment to Transaction Agreement and Plan of Merger dated as of March 27, 2017 (the "Transaction Agreement"), the Reporting Person became a Director of the Issuer. Exhibit 24 - Power of Attorney
/s/ Lee Whitley, Attorney-in-fact 07/03/2017
** 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.
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