FORM 3
UNITED STATES SECURITIES AND EXCHANGE COMMISSION | OMB APPROVAL |
Washington, D.C. 20549 | OMB Number: 3235-0104 |
Estimated average burden | |
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF | hours per response... 0.5 |
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
1. Name and Address of Reporting Person * | 2. Date of Event Requiring | 3. Issuer Name and Ticker or Trading Symbol | ||||||||||||||||||||
Statement (MM/DD/YYYY) | ||||||||||||||||||||||
BUSH WESLEY G | 5/21/2019 | CISCO SYSTEMS, INC. [CSCO] | ||||||||||||||||||||
(Last) | (First) | (Middle) | 4. Relationship of Reporting Person(s) to Issuer (Check all applicable) | |||||||||||||||||||
170 WEST TASMAN DRIVE | __ X __ Director | _____ 10% Owner | ||||||||||||||||||||
_____ Officer (give title below) | _____ Other (specify below) | |||||||||||||||||||||
(Street) | 5. If Amendment, Date | 6. Individual or Joint/Group Filing (Check Applicable Line) | ||||||||||||||||||||
SAN JOSE, CA 95134 | Original Filed (MM/DD/YYYY) | _ X _ Form filed by One Reporting Person | ||||||||||||||||||||
___ Form filed by More than One Reporting Person | ||||||||||||||||||||||
(City) | (State) | (Zip) | ||||||||||||||||||||
Table I - Non-Derivative Securities Beneficially Owned | ||||||||||||||||||||||
1.Title of Security | 2. Amount of Securities | 3. Ownership | 4. Nature of Indirect Beneficial Ownership | |||||||||||||||||||
(Instr. 4) | Beneficially Owned | Form: Direct | (Instr. 5) | |||||||||||||||||||
(Instr. 4) | (D) or Indirect | |||||||||||||||||||||
(I) | ||||||||||||||||||||||
(Instr. 5) | ||||||||||||||||||||||
Common Stock | 0 | D | ||||||||||||||||||||
Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) | ||||||||||||||||||||||
1. Title of Derivate Security | 2. Date Exercisable | 3. Title and Amount of | 4. Conversion | 5. Ownership | 6. Nature of Indirect | |||||||||||||||||
(Instr. 4) | and Expiration Date | Securities Underlying | or Exercise | Form of | Beneficial Ownership | |||||||||||||||||
(MM/DD/YYYY) | Derivative Security | Price of | Derivative | (Instr. 5) | ||||||||||||||||||
(Instr. 4) | Derivative | Security: | ||||||||||||||||||||
Security | Direct (D) or | |||||||||||||||||||||
Date | Expiration | Title | Amount or Number of | |||||||||||||||||||
Indirect (I) | ||||||||||||||||||||||
Exercisable | Date | Shares | ||||||||||||||||||||
(Instr. 5) | ||||||||||||||||||||||
Explanation of Responses: | ||||||||||||||||||||||
Reporting Owners | ||||||||||||||||||||||
Reporting Owner Name / Address | Relationships | |||||||||||||||||||||
Director | 10% OwnerOfficerOther | |||||||||||||||||||||
BUSH WESLEY G | ||||||||||||||||||||||
170 WEST TASMAN DRIVE | X | |||||||||||||||||||||
SAN JOSE, CA 95134 | ||||||||||||||||||||||
Signatures | ||||||||||||||||||||||
/s/ Wesley G. Bush by Evan Sloves, Attorney-in-Fact | 5/22/2019 | |||||||||||||||||||||
**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 control number.
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS , that the undersigned hereby constitutes and appoints Prat Bhatt, Kelly Kramer, Mark Chandler and Evan Sloves, and each of them, his or her true and lawful attorney-in-fact to:
- execute for and on behalf of the undersigned, in the undersigned's capacity as a director or officer of Cisco Systems, Inc. (the
"Company"), any and all Form ID, or Form 3, 4 or 5 reports required to be filed by the undersigned in accordance with Section 16(a) of the Securities Exchange Act of 1934 and the rules thereunder with respect to transactions in Cisco securities;
- 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 ID, or Form 3, 4 or 5 report and timely file such report with the United States Securities and Exchange Commission and any stock exchange or similar authority; and
- take any other action of any type whatsoever in connection with the foregoing 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 his discretion.
The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform each and every act and thing whatsoever requisite, necessary, and 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 his or her 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 no such attorney‑in-fact, in serving in such capacity at the request of the undersigned, is hereby assuming, nor is the Company hereby assuming, any of the undersigned's 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 Form 3, 4 or 5 reports with respect to the undersigned's holdings of and transactions in securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys‑in-fact.
IN WITNESS WHEREOF , the undersigned has caused this Power of Attorney to be executed as of this 12th day of May, 2019.
Signature: /s/ Wesley G. Bush
Printed Name: Wesley G. Bush
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Cisco Systems Inc. published this content on 22 May 2019 and is solely responsible for the information contained herein. Distributed by Public, unedited and unaltered, on 22 May 2019 21:22:04 UTC