SEC 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
|Estimated average burden|
|hours per response:
1. Name and Address of Reporting Person*
|CONNAUGHT HOUSE, 1 BURLINGTON RD, FL. 4|
2. Date of Event Requiring Statement
3. Issuer Name and Ticker or Trading Symbol
Jazz Pharmaceuticals plc
[ JAZZ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
||Officer (give title below)
||Other (specify below)
|Global Head of R&D and CMO||
5. If Amendment, Date of Original Filed
6. Individual or Joint/Group Filing (Check Applicable Line)
||Form filed by One Reporting Person
||Form filed by More than One Reporting Person
|Table I - Non-Derivative Securities Beneficially Owned|
|1. Title of Security (Instr.
Amount of Securities Beneficially Owned (Instr.
||3. Ownership Form: Direct (D) or Indirect (I) (Instr.
||4. Nature of Indirect Beneficial Ownership (Instr.
Table II - Derivative Securities Beneficially Owned|
(e.g., puts, calls, warrants, options, convertible securities)
|1. Title of Derivative Security (Instr.
||2. Date Exercisable and Expiration Date
||3. Title and Amount of Securities Underlying Derivative Security (Instr.
||4. Conversion or Exercise Price of Derivative Security
||5. Ownership Form: Direct (D) or Indirect (I) (Instr.
||6. Nature of Indirect Beneficial Ownership (Instr.
||Amount or Number of Shares
|Explanation of Responses:|
|No securities are beneficially owned.|
||/s/ Larissa Schwartz as attorney in fact For: Karen L. Smith
||** Signature of Reporting Person
|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,
|** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
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,
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.|
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby constitutes and appoints each of
SUZANNE SAWOCHKA HOOPER, VALERIE PIERCE, SOFIA LOU and LARISSA SCHWARTZ signing
individually, the undersigned's true and lawful attorneys-in fact and agents to:
1) execute for and on behalf of the undersigned (a) Forms 3, 4 and 5 in accordance with
Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act") and the rules
thereunder and (b) Forms 144 in accordance with Rule 144 promulgated under the Securities Act of
1933, as amended, as such Rule may be amended from time to time (or any successor rule) ("Rule
2) do and perform any and all acts for and on behalf of the undersigned that may be
necessary or desirable to complete and execute such Forms 3, 4, 5 or 144 (collectively, the "Forms"),
complete and execute any amendment or amendments thereto, and timely file such Forms or
amendments with the U.S. Securities and Exchange Commission and any stock exchange or similar
3) take any other action of any nature whatsoever in connection with the foregoing which, in
the opinion of such attorney-in-fact, may be of benefit, in the best interest of, or legally required by, the
undersigned, including but not limited to executing and delivering for and on behalf of the undersigned
any seller's representation letter that may be required to be submitted to any broker effecting any sale of
securities issued by Jazz Pharmaceuticals plc (the "Company") for the account of 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 or any of its affiliates, assuming, any of the
undersigned's responsibilities to comply with (a) Section 16 of the Exchange Act and (b) all of the
applicable conditions of the Rule 144 safe harbor with respect to a sale of securities issued by the
This Power of Attorney shall remain in full force and effect until the earliest to occur of (a) the
undersigned is no longer required to file any Forms with respect to the undersigned's holdings of and
transactions in securities issued by the Company, (b) revocation by the undersigned in a signed writing
delivered to the foregoing attorneys-in-fact or (c) as to any attorney-in-fact individually, until such
attorney-in-fact shall no longer be employed by the Company or an affiliate of the Company.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of
this 13th day of April 2015.
/s/ Karen L. Smith
KAREN L. SMITH