SEC Filing | Zumiez 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^*

ELLIS ADAM CHRISTOPHER

(Last)

(First)

(Middle)

4001 204TH STREET SW

(Street)

LYNNWOOD

98036

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
03/08/2017

3. Issuer Name and Ticker or Trading Symbol
Zumiez Inc [ ZUMZ ]

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

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
President International

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	49,800⁽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)
Options (Right to buy)	03/16/2016	03/16/2025	Common Stock	3,170⁽²⁾	38.57	D
Options (Right to buy)	03/14/2017	03/14/2026	Common Stock	11,087⁽²⁾	19.7	D

Explanation of Responses:

1. The share total includes 949 shares acquired through the Zumiez Inc. Employee Stock Purchase Plan.

2. Twenty-five percent of the options subject to these grants vest each year on the anniversary of the grant dates.

	Chris K. Visser, Attorney-in-Fact	03/24/2017
	** 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.

Power of Attorney

	1.	Designation of Attorneys-in-Fact.  The
undersigned, hereby designates each of Chris K. Visser
and Josh Gaul, individuals with full power of
substitution, as my attorney-in-fact to act for me and
in my name, place and stead, and on my behalf in
connection with the matters set forth in Item 2 below.

	2.	Powers of Attorney-in-Fact.  Each attorney-
in-fact, as fiduciary, shall have the authority to sign
all such U.S. Securities and Exchange Commission
("SEC") reports, forms and other filings, specifically
including but not limited to Forms 3, 4, 5 and 144, as
such attorney-in-fact deems necessary or desirable in
connection with the satisfaction of my reporting
obligations under the rules and regulations of the SEC.

	3.	Effectiveness.  This power of attorney shall
become effective upon the execution of this document.

	4.	Duration.  This power of attorney shall
remain in effect until revoked by me.  This power of
attorney shall not be affected by disability of the
principal.

	5.	Revocation.  This power of attorney may be
revoked in writing at any time by my giving written
notice to the attorney-in-fact.  If this power of
attorney has been recorded, the written notice of
revocation shall also be recorded.

	Date:  March 9, 2017.

	__Adam Christopher Ellis____
	  Adam Christopher Ellis

STATE OF Washington	)
COUNTY OF Snohomish	)

SIGNED OR ATTESTED before me on 03/09/2017.

		__Robert T. Noble________
		Signature of Notary Public

		__Robert T. Noble_________
(SEAL)	Typed Name of Notary Public
		Residing at:Lynnwood, WA
		My commission expires: _02/10/19_