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*
|1000 CRANBERRY WOODS DRIVE|
|CRANBERRY WOODS TOWNSHIP
2. Date of Event Requiring Statement
3. Issuer Name and Ticker or Trading Symbol
MSA Safety Inc
[ MSA ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
|Vice President, CLO||
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.
|Common Stock, no par value
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:|
||Stephanie L. Sciullo
||** 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.|
POWER OF ATTORNEY
To Sign and File Reports under Section 16(a)
of the Securities Exchange Act of 1934,
under Rule 144 or any other Filings Required,
including Form ID and Schedule 13D,
Under the Federal Securities Laws
With Respect to Securities of MSA Safety Incorporated
KNOW ALL MEN BY THESE PRESENTS, that the undersigned hereby
constitutes and appoints Kenneth D. Krause, Richard W. Roda and Pasquale D.
Gentile, Jr., Esquire, and each of them, her true and lawful attorneys-in-fact
and agents, with full power of substitution, for the undersigned and in the
undersigneds name, place and stead, to sign any and all reports of the
undersigned under Section 16(a) of the Securities Exchange Act of 1934, under
Rule 144 or any other filings required, including Form ID and Schedule 13D,
under the Federal Securities Laws with respect to securities of MSA, and to file
the same with the Securities and Exchange Commission, granting unto said
attorneys-in-fact and agents, and each of them, full power and authority to do
and perform each and every act and thing requisite and necessary to be done as
fully to all intents and purposes as the undersigned might or could do in
person, hereby ratifying and confirming all that said attorneys-in-fact
agents or any of them, or his, her or their substitute or substitutes, may
lawfully do or cause to be done by virtue hereof. The undersigned acknowledges
that the foregoing attorneys-in-fact, in serving in such capacity at the request
of the undersigned, are not assuming any of the undersigneds responsibilities
to comply with the Federal Securities Laws.
This Power of Attorney shall remain in effect unless it is revoked
in writing by the undersigned or, if earlier as it relates to filing Forms 3, 4,
and 5 with respect to the undersigneds holdings of and transactions in
securities issued by MSA, until the undersigned is no longer required to file
such Forms 3, 4, and 5.
IN WITNESS WHEREOF, the undersigned has executed and delivered this
Power of Attorney the date set forth below.
Date: January 4, 2020
SIGNATURE: Stephanie L. Sciullo