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*
4201 WOODLAND ROAD |
PO BOX 69 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/20/2023
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3. Issuer Name and Ticker or Trading Symbol
NORTHERN TECHNOLOGIES INTERNATIONAL CORP
[ NTIC ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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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)
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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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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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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 |
Explanation of Responses: |
No securities are beneficially owned. |
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/s/ Matthew C. Wolsfeld, attorney-in fact |
01/23/2023 |
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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
Cristina Lucia Duarte Pinho
With respect to holdings of and transactions in securities
issued by Northern Technologies International Corporation
(the Company), the undersigned hereby constitutes and
appoints the individuals listed on Schedule A attached
hereto and as may be amended from time to time, or any
of them signing singly, with full power of substitution and
resubstitution, to act as the undersigned's true and
lawful attorney-in-fact to:
1. prepare, execute, and submit to the United
States Securities and Exchange Commission (SEC) a Form
ID, Uniform Application For Access Codes To File On Edgar,
including amendments thereto, and any other documents
necessary or appropriate to obtain codes and passwords
enabling the undersigned to make electronic filings
with the SEC of reports required or considered by the
attorney-in-fact to be advisable under Section 13 or
Section 16 of the United States Securities Exchange Act
of 1934, as amended, or any rule or regulation of the SEC;
2. prepare, execute for and on behalf of the
undersigned, Forms 3, 4, and 5 in accordance with Section
16 of the United States Securities Exchange Act of 1934,
as amended, and any Form 144 in accordance with Rule 144
under the United States Securities Act of 1933, as amended,
and the rules and regulations thereunder;
3. 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 Form ID, Form 3, 4,
or 5 or Form 144 or complete and execute any amendment
or amendments thereto, and timely file such forms with
the SEC and any stock exchange or similar authority; and
4. 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 interest 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 the discretion of
such attorney-in-fact.
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
resubstitution or 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
Power of Attorney and the rights and powers herein
granted.
The undersigned hereby acknowledges that the attorneys-
in-fact, in serving in such capacity at the request of
the undersigned, are not assuming, nor is the Company
assuming, any of the undersigned's responsibilities to
comply with Section 16 of the Securities Exchange Act
of 1934, as amended, or Rule 144 of the Securities Act
of 1933, as amended, and any similar law, rule or
regulation.
This Power of Attorney shall remain in full force and
effect until the undersigned is no longer required to
file Forms 3, 4, and 5 and Forms 144 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 caused this
Power of Attorney to be executed as of this 20th day
of December
2023.
/s/ Cristina Lucia Duarte Pinho
Cristina Lucia Duarte Pinho
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Shedule A
Individuals Appointed as Attorney-in-Fact with Full Power
of Substitution and Resubstitution
1. G. Patrick Lynch, President and Chief Executive Officer
2. Matthew C. Wolsfeld, Chief Financial Officer and
Secretary
3. Amy E. Culbert, Partner, Fox Rothschild, LLP
4. Emily Humbert, Associate, Fox Rothschild LLP