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*
Mock James M

(Last) (First) (Middle)
940 WINTER STREET

(Street)
WALTHAM MA 02451

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/01/2018
3. Issuer Name and Ticker or Trading Symbol
PERKINELMER INC [ PKI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Please See Remarks
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:
Senior Vice President and Chief Financial Officer Exhibit List: Exhibit 24 - Power of Attorney
No securities are beneficially owned.
/s/ John L. Healy (POA on file) for James M. Mock 05/01/2018
** 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

                               Power of Attorney

     The undersigned hereby constitutes and appoints each of Joel S. Goldberg
and John L. Healy, each signing singly and acting individually, 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 PerkinElmer, Inc. (the
           "Company"), Forms 3, 4 and 5 (including any amendments thereto) in
           accordance with Section 16(a) of the Securities Exchange Act of 1934
           (the "Exchange Act") and the rules thereunder; and

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

     (3)   seek or obtain, as the undersigned's representative and on the
           undersigned's behalf, information regarding transactions in the
           Company's securities from any third party, including brokers,
           employee benefit plan administrators, stock option administrators,
           and trustees, and the undersigned hereby authorizes any such person
           to release any such information
 to such attorney-in-fact and approves
           and ratifies any such release of information; and

     (4)   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 neither the Company nor any of the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, assume (i) any liability for the undersigned's responsibility to
comply with the requirements of Section 16 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 any profit
disgorgement under Section 16(b) of the Exchange Act.

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

     IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be
executed this 24th day of March, 2018.


                                         /s/ James M. Mock
                                         ------------------------
                                         Signature

                                         James M. Mock
                                         ------------------------
                                         Print Name