SEC Filing - NCS Multistage Holdings, Inc

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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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1. Name and Address of Reporting Person^*

LEV ORI

(Last)

(First)

(Middle)

C/O NCS MULTISTAGE HOLDINGS, INC.

19350 STATE HIGHWAY 249, SUITE 600

(Street)

HOUSTON

77070

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
05/06/2020

3. Issuer Name and Ticker or Trading Symbol
NCS Multistage Holdings, Inc. [ NCSM ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
General Counsel

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	21,155⁽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)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	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)
Equivalent Stock Units	⁽³⁾	⁽³⁾	Common Stock	69,741	⁽²⁾	D
Option (right to buy)	⁽⁴⁾	04/27/2027	Common Stock	12,647	17	D

Explanation of Responses:

1. Includes 1,960 restricted stock units which vest on March 1, 2021, 5,198 restricted stock units which vest in two equal annual installments beginning on February 28, 2021, and 4,520 restricted stock units which vest in two equal annual installments beginning on April 1, 2021.

2. These equivalent stock units settle in cash and represent the economic equivalent of one share of common stock, provided that the amount of cash settled for any equivalent stock unit will not exceed the maximum payout established by the Compensation, Nominating and Governance Committee.

3. Includes 5,198 equivalent stock units which vest in two equal annual installments beginning on February 28, 2021, 4,520 equivalent stock units which vest in two equal annual installments beginning on April 1, 2021 and 60,023 equivalent stock units which vest in three equal annual installments beginning on February 28, 2021.

4. Includes 12,647 vested and exercisable options.

Remarks:

See Exhibit 24.1 - Power of Attorney.

	/s/ Ori Lev	05/11/2020
	** 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.

POWER OF ATTORNEY

May 6, 2020

       	Know all by these present, that the undersigned hereby constitutes
 and appoints Robert Nipper and Ryan Hummer, or any one of them signing singly,
 and with full power of substitution, the undersigned's true and lawful
 attorney-in-fact to:

(1)	execute for and on behalf of the undersigned, in the undersigned's
 capacity as an officer and/or director of NCS Multistage Holdings, Inc.
(the "Company") or as a stockholder of the Company or as a trustee of a
 stockholder of the Company, Forms 3, 4, and 5 and Schedules 13D or 13G,
 including amendments thereto, relating to the securities of the Company
 in accordance with Section 16(a) of the Securities Exchange Act of 1934
 and the rules thereunder;

(2)	do and perform any and all acts for and on behalf of the undersigned
 which may be necessary or desirable to complete and execute any such Form 3,
 4, or 5 or Schedule 13D or 13G, complete and execute any amendment or
 amendments thereto, and timely file such form with the United States
 Securities and Exchange Commission and any stock exchange or similar
 authority; and

(3)	take any other action of any type whatsoever in connection with the
 foregoing which, in the opinion of such attorney-in-fact, may be of benefit
 to, in the best interest of, or legally required by, 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 assuming, any of the undersigned's responsibilities to
 comply with, or liabilities that may arise under, Section 16 of the
 Securities Exchange Act of 1934.

       	This Power of Attorney shall remain in full force and effect
 until the undersigned is no longer required to file Forms 3, 4, and 5 or
 Schedules 13D or 13G with respect to the undersigned's holdings of
 and transactions in securities issued by the Company, unless earlier
 revoked by the undersigned in a signed writing delivered to the foregoing
 attorneys-in-fact.

	This Power of Attorney shall not revoke any powers of attorney
	previously executed by the undersigned.  This Power of Attorney shall
 not be revoked by any subsequent power of attorney that the undersigned
 may execute, unless such subsequent power of attorney specifically provides
 that it revokes this Power of Attorney by referring to the date of the
 undersigned's execution of this Power of Attorney.

[The remainder of this page has been intentionally left blank]

	IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney
 to be executed as of the day and year first above written.



/s/ Ori Lev
Signature

Ori Lev
Printed Name
[Signature Page to Power of Attorney]