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*
| C/O HASBRO, INC. |
| 1011 NEWPORT AVENUE |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
02/06/2013
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3. Issuer Name and Ticker or Trading Symbol
HASBRO INC
[ HAS ]
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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 Commercial Officer |
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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 |
|---|
| 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)
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| Common Stock (Par Value $.50 per share) |
28,667 |
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)
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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 |
|
Stock Option (Right to Buy)
|
|
05/23/2014 |
Common Stock |
43,203 |
32.425 |
D |
|
|
Stock Option (Right to Buy)
|
|
02/15/2015 |
Common Stock |
48,148 |
27.095 |
D |
|
|
Stock Option (Right to Buy)
|
|
05/20/2016 |
Common Stock |
21,006 |
22.73 |
D |
|
|
Stock Option (Right to Buy)
|
|
02/03/2017 |
Common Stock |
46,992 |
31.625 |
D |
|
|
Stock Option (Right to Buy)
|
|
02/08/2018 |
Common Stock |
28,844 |
45.66 |
D |
|
|
Stock Option (Right to Buy)
|
|
02/07/2019 |
Common Stock |
65,000 |
36.135 |
D |
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| Explanation of Responses: |
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Tarrant Sibley, P/O/A for Wiebe Tinga |
02/11/2013 |
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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. |
POWER OF ATTORNEY
I, Wiebe Tinga, hereby constitute and appoint each
of Tarrant Sibley, Cynthia McMakin and Mary Zeh,
acting individually as my true and lawful attorneys-
in-fact, with full power and authority as described
herein, on my behalf and in my name, place and stead
to:
(1) prepare, execute, acknowledge, deliver and file
with the United States Securities and Exchange
Commission and any stock exchanges, for and on my
behalf, in my capacity as an officer and/or director
of Hasbro, Inc. (the "Company"), and with respect to
the securities of the Company, Forms 3, 4 and 5 in
accordance with Section 16(a) of the Securities
Exchange Act of 1934, as amended, and the rules
thereunder (collectively the "Exchange Act"),
all to the extent deemed necessary and advisable
by such attorneys-in-fact;
(2) do and perform any and all acts for and on my
behalf that may be necessary or desirable to complete
and execute any such Forms 3, 4 or 5 and timely file
such forms with the United States Securities and
Exchange Commission and any stock exchange or similar
authority, including without limitation, to apply
for EDGAR filing codes for me and to take such steps
as are necessary to maintain such EDGAR filing codes;
and
(3) seek or obtain, as my representative and on my
behalf, information with respect to transaction in
the Company's securities from any third party,
including brokers, employee benefit plan
administrators and trustees, and I hereby authorize
any such person to release any such information
to the attorneys-in-fact and approve and ratify
such release of information; and
(4) take any other action of any type whatsoever in
connection with the foregoing which, in the opinion
of such attorneys-in-fact, may be to my benefit, in
my best interest, or that I am legally required to
do, it being understood that the documents executed
by such attorneys-in-fact on my behalf pursuant to
this Power of Attorney shall be in such form and
shall contain such terms and conditions as such
attorneys-in-act may approve in such attorney-in-
fact's discretion.
I hereby grant 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 I might or could do if
personally present, with full power of substitution
or revocation, hereby ratifying and confirming all
that such attorneys-in-fact, or such attorney-in-
fact's 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.
I hereby acknowledge that (i) this Power of Attorney
authorizes, but does not require, the attorney-in-fact
to act in his or her discretion on information
provided to the attorney-in-fact without independent
verification, (ii) the attorneys-in-fact, in serving
in such capacity at my request, are not assuming,
nor is the Company assuming, any of my
responsibilities to comply with Section 16 of the
Exchange Act, as amended, or the rules and regulations
promulgated thereunder, and are not assuming any
liabilities for either my responsibilities to comply
with the requirements of the Exchange Act or for any
liability for profit disgorgement under Section 16(b)
of the Exchange Act and (iii) any documents prepared
and/or received by the attorneys-in-fact on my behalf
will be in such form and will contain such information
as the attorney-in-fact, in his or her discretion,
deems necessary or advisable.
This Power of Attorney shall remain in full force and
effect until I am no longer required to file Forms 3,
4 and 5 with respect to my holdings of and transactions
in Company securities or security-based swap agreements,
unless I earlier revoke it in a signed writing delivered
to the attorneys-in-act.
IN WITNESS WHEREOF, I have caused this Power of Attorney
to be executed as of this 6th day of February, 2013.
/s/ Wiebe Tinga
________________________
Signature
Wiebe Tinga
________________________
Print Name
