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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
1001 PENNSYLVANIA AVENUE, NW |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 03/08/2021
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3. Issuer Name and Ticker or Trading Symbol
Carlyle Group Inc.
[ CG ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
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10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Common Stock |
4,193 |
I |
See Footnote
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
Remarks: |
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/s/ Jeffrey W. Ferguson, by Power of Attorney for Derica W. Rice |
03/17/2021 |
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** 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. |
Exhibit 24.1
POWER OF ATTORNEY AND CONFIRMING STATEMENT
This Power of Attorney and Confirming Statement (this "Statement") confirms that
the undersigned has authorized and designated each of Kewsong Lee, Curtis Buser,
Jeffrey Ferguson and Anne Frederick to execute and file on the undersigned's
behalf all Forms 3, 4, and 5 (including any amendments thereto) that the
undersigned may be required to file with the U.S. Securities and Exchange
Commission as a result of the undersigned's ownership of or transactions in
securities of The Carlyle Group Inc. (the "Company"). The authority of Kewsong
Lee, Curtis Buser, Jeffrey Ferguson and Anne Frederick under this Statement
shall continue until the undersigned is no longer required to file Forms 3, 4,
and 5 with regard to his ownership of or transactions in securities of The
Carlyle Group Inc., unless earlier revoked in writing. The undersigned
acknowledges that Kewsong Lee, Curtis Buser, Jeffrey Ferguson and Anne Frederick
are not assuming any of the undersigned's responsibilities to comply with
Section 16 of the Securities Exchange Act of 1934, as amended.
In witness whereof, this Statement is signed and dated as of the date set forth
below.
Date: March 8, 2021 By: /s/ Derica W. Rice
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Name: Derica W. Rice