0001209191-17-004998.txt : 20170120 0001209191-17-004998.hdr.sgml : 20170120 20170120201113 ACCESSION NUMBER: 0001209191-17-004998 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20170117 FILED AS OF DATE: 20170120 DATE AS OF CHANGE: 20170120 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Zeltiq Aesthetics Inc CENTRAL INDEX KEY: 0001415336 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 270119051 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4698 Willow Road STREET 2: Suite 100 CITY: Pleasanton STATE: CA ZIP: 94588-2710 BUSINESS PHONE: (925) 474-2500 MAIL ADDRESS: STREET 1: 4698 Willow Road STREET 2: Suite 100 CITY: Pleasanton STATE: CA ZIP: 94588-2710 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Harrison Danika R CENTRAL INDEX KEY: 0001547535 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35318 FILM NUMBER: 17539685 MAIL ADDRESS: STREET 1: C/O ZELTIQ AESTHETICS, INC. STREET 2: 4410 ROSEWOOD DRIVE CITY: PLEASANTON STATE: CA ZIP: 94588 3 1 doc3.xml FORM 3 SUBMISSION X0206 3 2017-01-17 0 0001415336 Zeltiq Aesthetics Inc ZLTQ 0001547535 Harrison Danika R C/O ZELTIQ AESTHETICS, INC. 4410 ROSEWOOD DRIVE PLEASANTON CA 94588 0 1 0 0 SVP of Global Marketing Common Stock 7482 D Common Stock 1712 D Common Stock 3992 D Common Stock 6567 D Represents grant of restricted stock units payable solely in common stock that vest in four equal annual installments, with the vesting commencement date of November 24, 2014. Represents grant of restricted stock units payable solely in common stock that vest in four equal annual installments, with the vesting commencement date of March 14, 2015. Represents grant of restricted stock units payable solely in common stock that vest in four equal annual installments, with the vesting commencement date of March 14, 2016. /s/ Daniel Gorback, Attorney-in-Fact 2017-01-20 EX-24.3_696145 2 poa.txt POA DOCUMENT LIMITED POWER OF ATTORNEY FORPOWER OF ATTORNEY KNOW ALL BY THESE PRESENTS, that the undersigned hereby constitutes and appoints Sergio Garcia, Mark Foley and Daniel Gorback, and each of them individually, his true and lawful attorney-in-fact to: (1) Execute for and on behalf of the undersigned, in the undersigned's capacity as an officer, director and/or 10% or greater stockholder of ZELTIQ Aesthetics, Inc. (the "Company"), and any and all Form 3, 4 and 5 reports required to be filed by the undersigned in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended, and the rules thereunder; (2) 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 3, 4 or 5 report and timely file such report with the United States Securities and Exchange Commission and any stock exchange or similar authority; and (3) 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 his discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform each and every act and thing whatsoever requisite, necessary, and 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 or revocation, hereby ratifying and confirming all that such attorney-in-fact, or his 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 acknowledges that no such attorney-in-fact, in serving in such capacity at the request of the undersigned, is hereby assuming, nor is the Company hereby assuming, any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934, as amended. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Form 3, 4 and 5 reports 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 17th day of January 2017. /s/ Danika Harrison Signature Danika Harrison Print Name