0001209191-14-075456.txt : 20141215
0001209191-14-075456.hdr.sgml : 20141215
20141215172547
ACCESSION NUMBER: 0001209191-14-075456
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20141203
FILED AS OF DATE: 20141215
DATE AS OF CHANGE: 20141215
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: FLEETCOR TECHNOLOGIES INC
CENTRAL INDEX KEY: 0001175454
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389]
IRS NUMBER: 000000000
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 5445 TRIANGLE PARKWAY
STREET 2: SUITE 400
CITY: NORCROSS
STATE: GA
ZIP: 30092
BUSINESS PHONE: 800-877-9019
MAIL ADDRESS:
STREET 1: 5445 TRIANGLE PARKWAY
STREET 2: SUITE 400
CITY: NORCROSS
STATE: GA
ZIP: 30092
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Ashurov Ali
CENTRAL INDEX KEY: 0001628005
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35004
FILM NUMBER: 141287686
MAIL ADDRESS:
STREET 1: 5445 TRIANGLE PARKWAY
CITY: NORCROSS
STATE: GA
ZIP: 30092
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2014-12-03
0
0001175454
FLEETCOR TECHNOLOGIES INC
FLT
0001628005
Ashurov Ali
5445 TRIANGLE PARKWAY
NORCROSS
GA
30092
0
1
0
0
CEO Czech & Russia
Common Stock
20000
D
Employee Stock Options
132.24
2017-07-15
2024-07-15
Common Stock
44000
D
Employee Stock Options
23.00
2015-07-01
2020-12-14
Common Stock
26251
D
5,000 shares are subject to remaining time based vesting requirements and will vest on March 25, 2015.
Time based stock options that vest 22,000 each on July 15, 2017 and 2018, respectively
Time based stock options that vest 13,125 on July 1, 2015 and 13,126 on July 1, 2016
/s/ Sean Bowen, under power of attorney
2014-12-15
EX-24.3_549755
2
poa.txt
POA DOCUMENT
LIMITED POWER OF ATTORNEY FOR SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned's hereby makes, constitutes and
appoints Sean Bowen, Alissa Vickery and Crystal Williams, either one, as the
undersigned's true and lawful attorney-in-fact, with full power and authority as
hereinafter described on behalf of and in the name, place and stead of the
undersigned to:
(1) prepare, execute, acknowledge, deliver and file Forms 3, 4, and 5 (including
any amendments thereto) with respect to the securities of FleetCor Technologies,
Inc., a Delaware corporation (the "Company"), with the United States Securities
and Exchange Commission, any national securities exchanges and the Company, as
considered necessary or advisable under Section 16(a) of the Securities Exchange
Act of 1934 and the rules and regulations promulgated thereunder, as amended
from time to time (the "Exchange Act");
(2) seek or obtain, as the undersigned's representative and on the undersigned's
behalf, information on transactions in the Company's securities from any third
party, including brokers, employee benefit plan administrators and trustees, and
the undersigned hereby authorizes any such person to release any such
information to the undersigned and approves and ratifies any such release of
information; and
(3) perform any and all other acts which in the discretion of such
attorney-in-fact are necessary or desirable for and on behalf of the undersigned
in connection with the foregoing.
The undersigned acknowledges that:
(1) this Power of Attorney authorizes, but does not require, such
attorney-in-fact to act in their discretion on information provided to such
attorney-in-fact without independent verification of such information;
(2) any documents prepared and/or executed by such attorney-in-fact on behalf of
the undersigned pursuant to this Power of Attorney will be in such form and will
contain such information and disclosure as such attorney-in-fact, in his or her
discretion, deems necessary or desirable;
(3) neither the Company nor such attorney-in-fact assumes (i) any liability for
the undersigned's responsibility to comply with the requirement of the Exchange
Act, (ii) any liability of the undersigned for any failure to comply with such
requirements, or (iii) any obligation or liability of the undersigned for profit
disgorgement under Section 16(b) of the Exchange Act; and
(4) this Power of Attorney does not relieve the undersigned from responsibility
for compliance with the undersigned's obligations under the Exchange Act,
including without limitation the reporting requirements under Section 16 of the
Exchange Act.
The undersigned hereby gives and grants the foregoing attorney-in-fact full
power and authority to do and perform all and every act and thing whatsoever
requisite, necessary or appropriate to be done in and about the foregoing
matters as fully to all intents and purposes as the undersigned might or could
do if present, hereby ratifying all that such attorney-in-fact of, for and on
behalf of the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.
This Power of Attorney shall remain in full force and effect until revoked by
the undersigned in a signed writing delivered to such attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed as of this 10th day of June, 2014.
/s/ Ali Ashurov
Signature
Ali Ashurov
Print Name
STATE OF GEORGIA
COUNTY OF GWINNETT
On this 11th day of December, 2014, Ali Ashurov personally appeared before me,
and acknowledged that s/he executed the foregoing instrument for the purposes
therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
/s/ Cynthia W. Owen
Notary Public
March 21, 2016
My Commission Expires