0000899243-21-043264.txt : 20211105 0000899243-21-043264.hdr.sgml : 20211105 20211105160518 ACCESSION NUMBER: 0000899243-21-043264 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211022 FILED AS OF DATE: 20211105 DATE AS OF CHANGE: 20211105 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Goldberg Joel S CENTRAL INDEX KEY: 0001440132 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05075 FILM NUMBER: 211384486 MAIL ADDRESS: STREET 1: 940 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PERKINELMER INC CENTRAL INDEX KEY: 0000031791 STANDARD INDUSTRIAL CLASSIFICATION: LABORATORY ANALYTICAL INSTRUMENTS [3826] IRS NUMBER: 042052042 STATE OF INCORPORATION: MA FISCAL YEAR END: 1229 BUSINESS ADDRESS: STREET 1: 940 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 BUSINESS PHONE: 781-663-5791 MAIL ADDRESS: STREET 1: 940 WINTER STREET CITY: WALTHAM STATE: MA ZIP: 02451 FORMER COMPANY: FORMER CONFORMED NAME: EG&G INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: EDGERTON GERMESHAUSEN & GRIER INC DATE OF NAME CHANGE: 19670626 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-10-22 0 0000031791 PERKINELMER INC PKI 0001440132 Goldberg Joel S 940 WINTER STREET WALTHAM MA 02451 0 1 0 0 Please See Remarks Common Stock 2021-10-22 5 G 0 E 63709 0.00 D 12405 D Common Stock 2021-10-22 5 G 0 E 63709 0.00 A 63709 I By Goldberg Irrevocable 2021 Trust The securities gifted by the reporting person were transferred to an irrevocable trust for the sole benefit of the reporting person's children. The reporting person's spouse is the trustee of the trust. The reporting person disclaims beneficial ownership of these securities, and the filing of this report is not an admission that the reporting person is the beneficial owner of these securities for purposes of Section 16 or for any other purpose. Senior Vice President, Administration, General Counsel and Secretary /s/ John L. Healy (POA on file) for Joel S. Goldberg 2021-11-05