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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1. Name and Address of Reporting Person*
Narula Sanjeev

(Last) (First) (Middle)
C/O UPJOHN INC.
235 EAST 42ND STREET

(Street)
NEW YORK NY 10017

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/06/2020
3. Issuer Name and Ticker or Trading Symbol
Upjohn Inc [ VTRS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Financial Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
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) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock, par value $0.01 per share 0 D
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) 4. Conversion or Exercise Price of Derivative Security 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:
No securities are beneficially owned. On August 6, 2020, Pfizer Inc. ("Pfizer") made available to its shareholders an information statement with respect to the distribution of shares of common stock of Upjohn Inc. ("Upjohn") to Pfizer stockholders. Upjohn previously filed with the U.S. Securities and Exchange Commission a preliminary version of the information statement as part of a registration statement on Form 10 which became effective on June 30, 2020.
/s/ Susan E. Grant, by power of atty., for Sanjeev Narula 08/06/2020
** 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.
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                               POWER OF ATTORNEY

The undersigned hereby constitutes and appoints each of Tara J. Gabbai, Susan E.
Grant, Lori P. Hernando, Margaret M. Madden, Madelyn D. Purcell and Shehzad
Siddiqui as the undersigned's true and lawful attorney-in-fact and agent, and
grants each of them full power to act on behalf of the undersigned and in the
undersigned's name, place and stead, in any and all capacities, for the purpose
of completing and signing, on behalf of the undersigned,

   *   any Form 3, Form 4 or Form 5 required or permitted to be filed by the
       undersigned pursuant to Section 16 of the Securities Exchange Act of
       1934, as amended (the "Exchange Act"), and

   *   any and all other documents, including, without limitation, Form ID,
       necessary or desirable to facilitate the filing by the undersigned of
       forms under Section 16 of the Exchange Act,

with regard to the undersigned's ownership of or transactions in securities of
Upjohn Inc., including, without limitation, the power to complete and sign any
and all amendments to such forms and documents, if any, and to file such forms
and documents and amendments thereto with the Securities and Exchange
Commission, and to do and perform each and every act and thing requisite or
necessary to be done in connection with such forms and documents and amendments
thereto, as fully and to all intents and purposes as the undersigned might or
could do in person. The authority of Tara J. Gabbai, Susan E. Grant, Lori P.
Hernando, Margaret M. Madden, Madelyn D. Purcell and Shehzad Siddiqui under
this Power of Attorney shall continue until the undersigned is no longer
required to file Form 3, Form 4 or Form 5 with regard to the undersigned's
ownership of or transactions in securities of Upjohn Inc., unless earlier
revoked in writing.  The undersigned acknowledges that Tara J. Gabbai, Susan E.
Grant, Lori P. Hernando, Margaret M. Madden, Madelyn D. Purcell and Shehzad
Siddiqui are not assuming any of the undersigned's responsibilities to comply
with Section 16 of the Exchange Act.

 /s/ Sanjeev Narula
---------------------------------
Sanjeev Narula