SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MOSCH JAMES G

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

(Street)
YORK PA 17401

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
DENTSPLY SIRONA Inc. [ XRAY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President & CEO Consumables
3. Date of Earliest Transaction (Month/Day/Year)
02/25/2016
4. If Amendment, Date of Original Filed (Month/Day/Year)
02/29/2016
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/25/2016 M 2,924(1)(2) A $0 36,486 D
Common Stock 02/25/2016 M 17,972(1)(3) A $0 54,458 D
Common Stock 02/25/2016 F 9,575 D $60.74 44,883 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
PRSU (2) 02/25/2016 M 2,924(1)(2) 02/25/2016 02/25/2016 Common Stock 2,924 $0 11,019.546 D
RSU (Restricted Stock Unit) (3) 02/25/2016 M 17,972(1)(3) 02/25/2016 02/25/2016 Common Stock 17,972 $0 26,333.821 D
Explanation of Responses:
1. This amended Form 4 is filed solely for the purpose of reporting an aggregate of twenty-four (24) additional shares of common stock which were accrued through dividend equivalent rights (DERs) and not reported on the original Form 4.
2. Comprised of two thousand eight hundred seventy-seven (2,877) vested Performance Restricted Stock Units (PRSUs) plus forty-seven (47) DERs. The original Form 4 reported all PRSUs and forty-four (44) DERs. PRSUs convert into common stock on a 1:1 basis for no additional consideration.
3. Comprised of seventeen thousand six hundred seventy-six (17,676) vested Restricted Stock Units (RSUs) plus two hundred ninety-six (296) DERs. The original Form 4 reported all RSUs and two hundred seventy-five (275) DERs. RSUs convert into common stock on a 1:1 basis for no additional consideration.
Michael Friedlander, Attorney-In-Fact for James G. Mosch 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 4 (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).
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