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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
12/15/2020
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3. Issuer Name and Ticker or Trading Symbol
UNIVERSAL LOGISTICS HOLDINGS, INC.
[ ULH ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
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| 1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Common Stock, no par value |
3,009,800 |
D |
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Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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|---|
| 1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
| Remarks: |
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/s/ Edwin J. Lukas, as Attorney-in-Fact for Nora M. Moroun |
12/30/2020 |
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** 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. |
Exhibit 24.1
POWER OF ATTORNEY
For Securities Filings
The undersigned constitutes and appoints Edwin J. Lukas, Steven A.
Fitzpatrick, and Courtney C. Crouch, III, signing singly, as the undersigned's
true and lawful attorney-in-fact to:
(1) Prepare, execute in the undersigned name, and submit to the Securities
and Exchange Commission (the "SEC") a Form ID, including amendments
thereto, and any other documents necessary or appropriate to obtain
codes and passwords enabling the undersigned to make electronic
filings with the SEC of reports required by the SEC;
(2) Execute in the undersigned's capacity as a shareholder of Universal
Logistics Holdings, Inc. (the "Company") (a) Forms 3, 4, and 5
(including amendments thereto) in accordance with Section 16(a) of the
Securities Exchange Act of 1934, as amended, and the rules thereunder
(the "Exchange Act"), (b) Form 144, (c) Schedules 13D and 13G
(including amendments thereto) in accordance with Sections 13(d) and
13(g) of the Exchange Act, and (d) any other forms on reports the
undersigned may be required to file in connection with the
undersigned's ownership, acquisition, or disposition of securities of
the Company;
(3) 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, Form 144, or Schedule 13D or 13G (including amendments
thereto), or other form or report, and timely file such form or report
with the SEC and any stock exchange or similar authority; and
(4) Perform any other action that such attorney-in-fact deems necessary or
appropriate.
The undersigned grants to each attorney-in-fact the full power and
authority to perform every act required or necessary in the exercise of the
rights set forth in this Power of Attorney. This grant gives each attorney-in-
fact the full power of substitution or revocation, and the undersigned ratifies
and confirms all that such attorney-in-fact or his substitute shall lawfully do
by virtue of this Power of Attorney. The undersigned acknowledges that neither
the Company nor the foregoing attorneys-in-fact are assuming any of the
undersigned's responsibilities to comply with the securities laws.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4, or 5, Form 144 and
Schedules 13D and 13G (including amendments thereto), unless earlier revoked by
the undersigned in a signed writing delivered to the foregoing attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has signed this Power of Attorney as of
March 27, 2019.
/s/ Nora M. Moroun
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Signature
Nora M. Moroun
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Printed Name
