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*
2. Date of Event Requiring Statement
3. Issuer Name and Ticker or Trading Symbol
YRC Worldwide Inc.
[ YRCW ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
|Chief Customer Officer||
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.
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:|
|No securities are beneficially owned.|
||/s/Jason W. Bergman
||** 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
I am a director or Section 16 officer of YRC Worldwide Inc. (the
Company). In connection therewith, I file with the Securities and
Exchange Commission (Commission) under the Securities Exchange Act of
1934, as amended (Exchange Act), reports required in connection with
the purchase or sale of stock and derivative securities of the Company,
including but not limited to reports on initial ownership or changes in
beneficial ownership of the common stock of the Company on Form 3,
Form 4 or Form 5, and any amendments thereto as may be required by
the Commission pursuant to the Exchange Act and the rules and
regulations of the Commission promulgated thereunder, along with any
and all other documents relating thereto or in connection therewith,
including the Uniform Applications For Access Codes To File On
In my individual capacity, I hereby constitute and appoint
James A. Fry and Leah K. Dawson and each of them, either of whom may act
without the other, as my true and lawful attorneys-in-fact and
agents (Attorneys), with full power of substitution and re-substitution,
for me and in my name, place and stead, in any and all capacities, to
sign any and all Uniform Applications For Access Codes To File On
EDGAR, Forms 3, Forms 4 and Forms 5, any and all amendments
thereto, and any and all other documents related thereto or in connection
therewith, reporting on my beneficial ownership of the stock and
derivative securities of the Company and to file the same, with all
exhibits thereto, with the Commission granting unto said Attorneys full
power and authority to do and perform each and every act and thing
requisite and necessary to be done in and about the premises, as fully
and with all intents and purposes as might or could be done in person,
hereby ratifying and confirming all that said Attorneys or their
substitutes may lawfully do or cause to be done by virtue hereof.
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 securities of the Company, unless earlier
revoked by me in a signed writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, I have executed this Power of Attorney
as of July 9, 2019.
/s/Jason W. Bergman
Print Name: Jason W. Bergman
ANY PERSON RELYING ON THIS POWER OF ATTORNEY MAY RELY ON A
PHOTOCOPY AS IF IT WERE AN ORIGINAL.