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
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person*
| C/O ELDORADO RESORTS, INC. |
| 100 WEST LIBERTY STREET, 11TH FLOOR |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
05/01/2017
|
3. Issuer Name and Ticker or Trading Symbol
Eldorado Resorts, Inc.
[ ERI ]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
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)
|
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 |
| Explanation of Responses: |
| Remarks: |
|
| No securities are beneficially owned. |
|
/s/ Edmund L. Quatmann, Jr. as Attorney-in-Fact |
05/03/2017 |
|
** 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. |
LIMITED POWER OF ATTORNEY FOR GREGORY J. KOZICZ
BENEFICIAL OWNERSHIP REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby makes, constitutes and
appoints each of Anthony L. Carano, Thomas Reeg and Edmund L. Quatmann, Jr.,
each acting individually, as the undersigned's true and lawful attorney-in-fact,
with full power and authority as hereinafter described on behalf of and in the
name, place and stead of the undersigned to
(1) prepare, execute, acknowledge, deliver and file Schedules 13G, 13D,
Forms 3, 4, and 5 (including any amendments thereto), including
applications for Form ID, and any documents necessary to facilitate
the filing of beneficial ownership reports, with respect to the
securities of Eldorado Resorts Inc., a Nevada corporation (the
"Company"), with the United States Securities and Exchange Commission,
any national securities exchanges and the Company, as considered
necessary or advisable under Sections 13(d) and 16(a) of the
Securities Exchange Act of 1934 and the rules and regulations
promulgated thereunder, as amended from time to time (the "Exchange
Act");
(2) seek or obtain, as the undersigned's representative and on the
undersigned's behalf, information on transactions in the Company's
securities from any third party, including brokers, employee benefit
plan administrators and trustees, and the undersigned hereby
authorizes any such person to release any such information to the
undersigned and approves and ratifies any such release of information;
and
(3) perform any and all other acts which in the discretion of such
attorney-in-fact are necessary or desirable for and on behalf of the
undersigned in connection with the foregoing.
The undersigned acknowledges that:
(1) this Limited Power of Attorney authorizes, but does not require, each
such attorney-in-fact to act in his discretion on information provided
to such attorney-in-fact without independent verification of such
information;
(2) any documents prepared and/or executive by any such attorney-in-fact
on behalf of the undersigned pursuant to this Limited Power of
Attorney will be in such form and will contain such information and
disclosure as such attorney-in-fact, in his or her discretion, deems
necessary or desirable;
(3) neither the Company nor any such attorney-in-fact assumes:
(i) any liability for the undersigned's responsibility to comply
with the requirements of the Exchange Act, (ii) any
liability of the undersigned for any failure to comply with
such requirements, or (iii) any obligation or liability of
the undersigned for profit disgorgement under Sections 13(d)
and 16(b) of the Exchange Act; and
(4) this Limited Power of Attorney does not relieve the undersigned from
responsibility for compliance with the undersigned's obligations under
the Exchange Act, including without limitation the reporting
requirements under Sections 13(d) and 16 of the Exchange Act. The
undersigned hereby gives and grants each of the foregoing
attorneys-in-fact full power and authority to do and perform all and
every act and thing whatsoever requisite, necessary or appropriate to
be done in and about the foregoing matters as fully to all intents and
purposes as the undersigned might or could do if present, hereby
ratifying all that each such attorney-in-fact of, for and on behalf of
the undersigned, shall lawfully do or cause to be done by virtue of
this Limited Power of Attorney.
This Limited Power of Attorney shall remain in full force and effect until
revoked by the undersigned in a signed writing delivered to each such
attorney-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of
Attorney to be executed as of this 3rd day of May, 2017.
Signature
/s/ Gregory J. Kozicz
------------------------------
Gregory J. Kozicz
