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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1. Name and Address of Reporting Person*
Tate Leah

(Last) (First) (Middle)
C/O BELDEN INC.
1 N. BRENTWOOD BLVD., 15TH FLOOR

(Street)
SAINT LOUIS MO 63105

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/18/2022
3. Issuer Name and Ticker or Trading Symbol
BELDEN INC. [ BDC ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP - HR
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X 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. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 5,224 D
Common Stock 1,810 I By Spouse
Common Stock 616.0739(1) I By 401(k) Plan
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Appreciation Rights (2) 02/28/2029 Common Stock 1,163 $61.79 D
Stock Appreciation Rights (3) 02/11/2030 Common Stock 1,528 $51.14 D
Stock Appreciation Rights (4) 02/16/2031 Common Stock 1,748 $45.11 D
Stock Appreciation Rights (5) 02/22/2032 Common Stock 1,325 $53.79 D
Explanation of Responses:
1. Represents the balance of shares of Belden Inc. common stock held in the Belden Retirement Savings Plan as of the date of this filing.
2. 388 SARs became exercisable on February 28, 2020, 388 SARs became exercisable on February 28, 2021 and 387 became exercisable on February 28, 2022.
3. 510 SARs became exercisable on February 11, 2021 and 509 SARs became exercisable on February 11, 2022. The remaining 509 SARs are scheduled to become exercisable on February 11, 2023.
4. 583 SARs became exercisable on February 16, 2022. The remaining 1,165 SARs are scheduled to become exercisable in equal installments on February 16, 2023 and February 16, 2024.
5. The SARs became exercisable in three equal annual installments on February 22, 2023, February 22, 2024 and February 22, 2025.
Remarks:
/s/ Brian E. Anderson, attorney-in-fact for Leah Tate 03/25/2022
** 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.