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
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person*
| C/O LIVEPERSON |
| 530 7TH AVE, FLOOR M1 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
09/07/2023
|
3. Issuer Name and Ticker or Trading Symbol
LIVEPERSON INC
[ LPSN ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
|
10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
|
Chief Accounting Officer
|
|
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 |
|
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)
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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)
|
| Common Stock |
0
|
D |
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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)
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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)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
|
| Remarks: |
|
|
/s/ Monica L. Greenberg, Attorney-in-Fact for Jeffrey Ford |
09/15/2023 |
|
** 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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DocuSign Envelope ID: AC1B0C42-998C-46CA-AD90-95F53325E62E
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby constitutes and appoints John Collins,
James Potter and Monica Greenberg with full power of substitution, the undersignedTMs true and lawful
attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersignedTMs capacity as executive
officer, director and/or beneficial owner of equity securities of LivePerson, Inc. (the
Company), (i) any forms required to be filed by the undersigned pursuant to Rule 144
under the Securities Act of 1933, as amended (the Securities Act), (ii) Forms 3, 4 and 5
in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended
(the Exchange Act), (iii) Schedules 13D and 13G in accordance with Section 13 of the
Exchange Act and (iv) and any other forms or reports the undersigned may be required to
file in connection with the undersignedTMs ownership, acquisition, or disposition of
securities of the Company;
(2) 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 (i) form required to be filed by
the undersigned pursuant to Rule 144 under the Securities Act, (ii) Form 3, 4 or 5 under
Section 16(a) of the Exchange Act, (iii) Schedule 13D or 13G under Section 13 of the
Exchange Act or (iv) other form or report, including, without limitation, all forms or
reports necessary to obtain EDGAR Identification Numbers, and timely file such form or
report with the United States Securities and Exchange Commission and any stock
exchange or similar authority; and
(3) 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 interests 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 such attorney-in-factTMs 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 or revocation, hereby ratifying and
confirming all that such attorney-in-fact, or such attorney-in-factTMs 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 the foregoing attorney-in-fact, in serving in such capacity at the request of
the undersigned, is not assuming any of the undersignedTMs responsibilities to comply with Rule 144 under
the Securities Act or Sections 13 or 16 of the Exchange Act.
This Power of Attorney shall remain in full force and effect until the undersigned is no longer
required to file any form required to be filed by the undersigned pursuant to Rule 144 under the Securities
Act, any Form 3, 4 or 5 under Section 16(a) of the Exchange Act or any Schedule 13D or 13G under
Section 13 of the Exchange Act with respect to the undersignedTMs holdings of and transactions in
securities issued by the Company, unless earlier revoked by the undersigned in a signed writing delivered
to the foregoing attorney-in-fact.
1
61167776
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DocuSign Envelope ID: AC1B0C42-998C-46CA-AD90-95F53325E62E
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as
th
of this ___ day of August, 2023.
Jeffrey Ford
2
