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*
| 3900 WISCONSIN AVENUE, N.W. |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year)
05/27/2011
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3. Issuer Name and Ticker or Trading Symbol
FEDERAL NATIONAL MORTGAGE ASSOCIATION FANNIE MAE
[ FNMA ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
Director |
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10% Owner |
| X |
Officer (give title below) |
|
Other (specify below) |
| SVP-Head Underwritng & Pricing |
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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)
|
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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| 8.25% Non-Cumulative Series T Preferred Stock |
1,000 |
D |
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| Common Stock |
16,437 |
D |
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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 |
| Stock Option (Right to Buy) |
11/20/2002
|
11/20/2011 |
Common Stock |
6,980 |
80.95 |
D |
|
| Stock Option (Right to Buy) |
01/21/2004
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01/21/2013 |
Common Stock |
5,600 |
69.43 |
D |
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| Stock Option (Right to Buy) |
01/23/2005
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01/23/2014 |
Common Stock |
6,360 |
78.315 |
D |
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| Explanation of Responses: |
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|
/s/ Andrew Bon Salle |
05/26/2011 |
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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. |
LIMITED SIGNATORY POWER
By this Limited Signatory Power the undersigned authorizes and designates each
of Suzanne A. Barr, Judith C. Dunn, Stephen H. McElhennon and Veronique K. Fine
each with full power of substitution,to execute and file on behalf of the
undersigned all Forms 3, 4 and 5 (including any exhibits, attachments and
amendments thereto) that the undersigned may be required to file with the
Securities and Exchange Commission as a result of the undersigned's
ownership of or transactions in securities of Fannie Mae. The undersigned
further authorizes and designates each of Suzanne A. Barr, Judith C. Dunn,
Stephen H. McElhennon and Veronique K. Fine to execute and file on behalf
of the undersigned a Form ID, and any amendments thereto, to facilitate
the foregoing. The authority of Suzanne A. Barr, Judith C. Dunn,
Stephen H. McElhennon and Veronique K. Fine under this Limited Signatory
Power shall continue until the undersigned is no longer required to file
Forms 3, 4 and 5 with regard to his or her ownership of or transactions
in securities of Fannie Mae,unless earlier revoked in writing. The
undersigned acknowledges that Suzanne A. Barr, Judith C. Dunn, Stephen
H. McElhennon and Veronique K. Fine are not assuming, nor is Fannie Mae
assuming, any of the undersigned's responsibilities to file Forms 3, 4
and 5 or otherwise comply with any related laws or regulations.
This Limited Signatory Power revokes any Signatory Power or Power of Attorney
the undersigned has previously signed with respect to Forms 3, 4 and 5,
and Form IDs, that the undersigned may be required to file with the
Securities and Exchange Commission as a result of the undersigned's
ownership of or transactions in securities of Fannie Mae.
Date:________5/19/2011________ Signed: /s/ Andrew Bon Salle
