0001209191-17-008698.txt : 20170208
0001209191-17-008698.hdr.sgml : 20170208
20170208164149
ACCESSION NUMBER: 0001209191-17-008698
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20170206
FILED AS OF DATE: 20170208
DATE AS OF CHANGE: 20170208
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: WELLTOWER INC.
CENTRAL INDEX KEY: 0000766704
STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798]
IRS NUMBER: 341096634
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4500 DORR STREET
CITY: TOLEDO
STATE: OH
ZIP: 43615
BUSINESS PHONE: 419-247-2800
MAIL ADDRESS:
STREET 1: 4500 DORR STREET
CITY: TOLEDO
STATE: OH
ZIP: 43615
FORMER COMPANY:
FORMER CONFORMED NAME: HEALTH CARE REIT INC /DE/
DATE OF NAME CHANGE: 19920703
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KLIPSCH FRED S
CENTRAL INDEX KEY: 0001275510
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-08923
FILM NUMBER: 17583085
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2017-02-06
0
0000766704
WELLTOWER INC.
HCN
0001275510
KLIPSCH FRED S
C/O WELLTOWER INC.
4500 DORR STREET
TOLEDO
OH
43615
1
0
0
0
Common Stock
2017-02-06
4
M
0
562
0.00
A
562
D
Common Stock
15653
I
Revocable Trust
Deferred Stock Units
0.00
2017-02-06
4
M
0
562
0.00
D
2017-02-06
2017-02-06
Common
562
2298
D
The reported transaction was a vesting of 562 deferred stock units on February 6, 2017, resulting in the issuance of 562 shares of common stock. No amount was payable in connection with the vesting or the common stock issuance.
The Fredrick S. Klipsch 2010 Amended and Restated Revocable Trust UAD 4/8/2010.
These deferred stock units were granted without cash consideration on February 6, 2014 under the Amended and Restated Welltower Inc. 2005 Long-Term Incentive Plan. Each deferred stock unit represents a right to receive one share of common stock of Welltower Inc. at the time of vesting of the unit. These deferred stock units vest in three installments, with 563 units having vested on February 6 of each of 2015 and 2016 and 562 units having vested on February 6, 2017.
Includes 2,298 deferred stock units granted on February 12, 2016; with 2,298 units vesting on February 12, 2017.
By: Matthew McQueen
Attorney-in-Fact
For: Fred S. Klipsch
2017-02-08
EX-24.4_699905
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY FOR SECTION 16 FILINGS
The undersigned does hereby make, constitute and appoint Thomas J. DeRosa and
Matthew McQueen, and each of them acting individually, his true and lawful
attorneys for the purposes hereinafter set forth.
References in this Power of Attorney to "attorney-in-fact" are to each of the
persons named above and to the person or persons substituted hereunder pursuant
to the power of substitution granted herein.
The undersigned hereby grants to the attorney-in-fact, for the undersigned and
in his name, place and stead the power to:
(1) prepare and submit to the U.S. Securities and Exchange Commission (the
"SEC") a Form ID, including amendments thereto, and any other documents
necessary or appropriate to obtain codes, passwords, and passphrases enabling
the undersigned to make electronic filings with the SEC of reports required by
Section 16(a) of the Securities Exchange Act of 1934 or any rule or regulation
of the SEC;
(2) execute for and on behalf of the undersigned, in the undersigned's capacity
as an officer and/or director of Welltower Inc. (the "Company"), Forms 3, 4, and
5 in accordance with Section 16(a) of the Securities Exchange Act of 1934 and
the rules 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 3, 4, or 5,
complete and execute any amendment or amendments thereto, and file such form
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 such
attorney-in-fact's discretion.
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 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 acknowledges that the foregoing 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.
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 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 5th day of July, 2016.
/S/ Fred S. Klipsch
___________________________
Signature
Fred S. Klipsch
____________________________
Print Name