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*
MacInnis Maureen J.

(Last) (First) (Middle)
221 WEST PHILADELPHIA STREET STE 60 W

(Street)
YORK PA 17401

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
04/07/2016
3. Issuer Name and Ticker or Trading Symbol
DENTSPLY SIRONA Inc. [ XRAY ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Sr VP & Chief HR Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
04/18/2016
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 13,533(1) D
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
PRSU (Performance Measured Restricted Stock Unit) (2) (2) Common Stock 5,202.8(2) (2) D
RSU (Restricted Stock Unit) (3) (3) Common Stock 10,749.958(3) (3) D
Supplemental Executive Retirement Plan (SERP) (4) (4) Common Stock 6,637 (4) D
Stock Option (Right to Buy) 04/14/2010(5) 04/14/2019 Common Stock 17,650 $26.72 D
Stock Option (Right to Buy) 12/08/2010(5) 12/08/2010 Common Stock 23,200 $33.86 D
Stock Option (Right to Buy) 02/11/2012(5) 02/11/2021 Common Stock 21,900 $36.62 D
Stock Option (Right to Buy) 02/21/2013(5) 02/21/2022 Common Stock 18,300 $38.74 D
Stock Option (Right to Buy) 02/25/2014(5) 02/25/2023 Common Stock 13,800 $40.86 D
Stock Option (Right to Buy) 02/24/2015(6) 02/24/2024 Common Stock 15,000 $45.11 D
Stock Option (Right to Buy) 02/23/2016(7) 02/23/2025 Common Stock 14,800 $52 D
Stock Option (Right to Buy) 02/17/2017(8) 02/17/2026 Common Stock 12,100 $55.91 D
Explanation of Responses:
1. This amended Form 3 is filed solely for the purpose of reporting three (3) additional shares of common stock which were not reported on the original Form 3. The original Form 3 reported 13,530 shares of common stock.
2. Comprised of five thousand one hundred forty-seven (5,147) unvested Performance Restricted Stock Units (PRSUs) plus fifty-five and eighty hundredths (55.80) dividend equivalent rights (DERs). PRSUs vest in full three years from date of grant and convert into common stock on a 1:1 basis for no additional consideration.
3. Comprised of ten thousand six hundred seventy-three (10,673) unvested Restricted Stock Units (RSUs) plus seventy-six and nine hundred fifty-eight thousandths (76.958) DERs. RSUs vest in full three years from date of grant and convert into common stock on a 1:1 basis for no additional consideration.
4. Value paid in stock following the reporting person's retirement.
5. This option is fully vested and exercisable.
6. Stock Options vest in annual one-third (1/3) increments over a three-year period ending February 24, 2017.
7. Stock Options vest in annual one-third (1/3) increments over a three-year period ending February 23, 2018.
8. Stock Options vest in annual one-third (1/3) increments over a three-year period ending February 17, 2019.
Michael Friedlander, Attorney-In-Fact for Maureen J. MacInnis 10/28/2016
** 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.
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