SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

OMB APPROVAL

Washington, D.C. 20549

OMB Number:

3235-0104

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF

Estimated average burden

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

3. Issuer Name and Ticker or Trading Symbol

Carpenter Tod E.

Requiring Statement

AMETEK INC/[ AME ]

(Month/Day/Year)

06/17/2019

4. Relationship of Reporting Person(s) to Issuer

5. If Amendment, Date of Original Filed

(Last)

(First)

(Middle)

(Check all applicable)

(Month/Day/Year)

1400 WEST 94TH STREET

X Director

10% Owner

6. Individual or Joint/Group Filing (Check

Officer (give title

Other (specify

Applicable Line)

below)

below)

X

Form filed by One Reporting

(Street)

Person

BLOOMINGTON MN

55431-2303

Form filed by More than One

Reporting Person

(City)

(State)

(Zip)

Table I - Non-Derivative Securities Beneficially Owned

1. Title of Security (Instr. 4)

2. Amount of Securities

3. Ownership

4. Nature of Indirect Beneficial Ownership

Beneficially Owned (Instr. 4)

Form: Direct (D)

(Instr. 5)

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 Derivative Security (Instr. 4)

2. Date Exercisable and

3. Title and Amount of Securities

4.

5.

6. Nature of Indirect

Expiration Date

Underlying Derivative Security (Instr.

Conversion

Ownership

Beneficial Ownership

(Month/Day/Year)

4)

or

Form:

(Instr. 5)

Exercise

Direct (D)

Amount

Price of

or Indirect

or

Derivative

(I) (Instr. 5)

Date

Expiration

Number

Security

of

Exercisable

Date

Title

Shares

Explanation of Responses:

/s/ Tod. E. Carpenter

06/17/2019

** 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 Number.

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Ametek Inc. published this content on 17 June 2019 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 18 June 2019 09:03:09 UTC