FORM 3 - Highlands REIT

SEC Form 3
UNITED STATES SECURITIES AND EXCHANGE
COMMISSION
FORM 3
Washington, D.C. 20549
OMB APPROVAL
OMB Number:
32350104
Estimated average burden
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP
OF SECURITIES
hours per
response:
0.5
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*
Lange Robert J.
2. Date of Event
Requiring Statement
(Month/Day/Year)
3. Issuer Name and Ticker or Trading Symbol
Highlands REIT, Inc. [ NONE ]
06/01/2016
(Last)
(First)
4. Relationship of Reporting Person(s) to
Issuer
(Check all applicable)
Director
10% Owner
(Middle)
C/O HIGHLANDS REIT, INC.
332 S MICHIGAN AVENUE,
NINTH FLOOR
Officer (give
title below)
X
Other (specify
below)
See Remarks
(Street)
CHICAGO IL
60604
(City)
(Zip)
(State)
5. If Amendment, Date of Original
Filed (Month/Day/Year)
6. Individual or Joint/Group Filing
(Check Applicable Line)
filed by One Reporting
X Form
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)
5,779
D
Common Stock
4. Nature of Indirect Beneficial
Ownership (Instr. 5)
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)
Date
Expiration
Exercisable Date
Title
4.
Conversion
or Exercise
Price of
Amount Derivative
or
Security
Number
of
Shares
5.
Ownership
Form:
Direct (D)
or Indirect
(I) (Instr. 5)
6. Nature of
Indirect
Beneficial
Ownership
(Instr. 5)
Explanation of Responses:
Remarks:
Executive Vice President, General Counsel and Secretary Exhibit List: Exhibit 24 - Power of Attorney
/s/ Robert J. Lange
06/03/2016
** 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.
EX-24 2 attachment1.htm EX-24 DOCUMENT
LIMITED POWER OF ATTORNEY
For Filings under Section 16 of the Securities Exchange Act of 1934
(Highlands REIT, Inc.)
The undersigned hereby constitutes and appoints Richard Vance, President
and Chief Executive Officer of Highlands REIT, Inc. (the "Company"),and Joseph
Giannini, Principal Accounting Officer and Treasurer of the Company, each in
their respective capacities as such, and each of their respective successors in
such offices, and each of them, the undersigned's true and lawful attorneys-infact and agents, with full power of substitution in the premises, for the
undersigned and in the undersigned's name, place and stead, in any and all
capacities, to:
(1)
execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Company, Forms 3, 4 and
5 in accordance with Section 16(a) of the Securities Exchange Act
of 1934, as amended (the "Exchange Act"), and the rules
thereunder;
(2)
do and perform any and all acts for and on behalf of the
undersigned that may be necessary or desirable to complete and
execute any such Form 3, 4 or 5 and timely file such form with the
United States Securities and Exchange Commission and any stock
exchange or similar authority; and
(3)
take any other action solely 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 or on behalf
of, the undersigned, it being understood that the documents
executed by such attorney-in-fact on behalf of the undersigned
pursuant to this Limited Power of Attorney shall be in such form
and shall contain such terms and conditions as such attorney-infact may approve in such attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power and
authority to do and perform any and every act and thing whatsoever requisite,
necessary, or 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 and revocation,
hereby ratifying and confirming all that such attorney-in-fact, or such
attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be
done by virtue of this Limited Power of Attorney and the rights and powers
herein granted. The undersigned acknowledges that each of the foregoing
attorneys-in-fact, in serving in such capacity at the request of the
undersigned, is not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 of the Exchange Act.
This Limited Power of Attorney shall remain in full force and effect until
the undersigned is no longer required to file Forms 3, 4 and 5 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 executed this Limited Power of
Attorney this 3rd day of June, 2016.
/s/ Robert J. Lange
---------------------Robert J. Lange