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*
HERITAGE HALL, LE MARCHANT STREET |
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(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/01/2020
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3. Issuer Name and Ticker or Trading Symbol
Intelsat S.A.
[ I ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
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)
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Form filed by One Reporting Person |
X |
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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Common Shares |
48,468,543 |
I |
See footnote
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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 |
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
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(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
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1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
|
1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
|
(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
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1. Name and Address of Reporting Person*
HERITAGE HALL, LE MARCHANT STREET |
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(Street)
ST. PETER PORT |
Y7 |
X0 GY1 4HY |
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Explanation of Responses: |
Remarks: |
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/s/ Jason Schaefer as attorney-in-fact |
02/04/2020 |
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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. |
Exhibit 99.1
JOINT FILER INFORMATION
Name of Reporting Person: Serafina S.A.
Address of Reporting Person: 29, avenue de la Porte Neuve, L 2227 Luxembourg
Name of Designated Filer: CIE Management II Limited
Name of Reporting Person: LMBO Europe SAS
Address of Reporting Person: 58 60 Avenue Kleber, Paris, France 75116
Name of Designated Filer: CIE Management II Limited
Name of Reporting Persons: CIE Management II Limited, BC European Capital VIII 1
to 7 (inclusive)
Address of Reporting Persons: Heritage Hall, Le Marchant Street, St. Peter Port,
Guernsey, GY1 4HY
Name of Designated Filer: CIE Management II Limited
Name of Reporting Persons: BC European Capital VIII 8 to 12 (inclusive) and 14
to 18 (inclusive)
Address of Reporting Persons: Heritage Hall, Le Marchant Street, St. Peter Port,
Guernsey, GY1 4HY
Name of Designated Filer: BC European Capital VIII 8
Name of Reporting Persons: BC European Capital VIII 19 to 28 (inclusive)
Address of Reporting Persons: Heritage Hall, Le Marchant Street, St. Peter Port,
Guernsey, GY1 4HY
Name of Designated Filer: BC European Capital VIII 19
Name of Reporting Persons: BC European Capital VIII 29 to 34 (inclusive) and 37,
and BC European Capital VIII 35 SC, 36 SC and 38 SC
Address of Reporting Persons: Heritage Hall, Le Marchant Street, St. Peter Port,
Guernsey, GY1 4HY
Name of Designated Filer: BC European Capital VIII 29
Name of Reporting Persons: BC European Capital VIII 39 SC, BC European Capital
Intelsat Co Investment and BC European Capital Intelsat Co Investment 1
Address of Reporting Persons: Heritage Hall, Le Marchant Street, St. Peter Port,
Guernsey, GY1 4HY
Name of Designated Filer: BC European Capital VIII 39 SC