SEC Form 4 · accession 0001209191-15-077506
Restaurant Brands International Inc. · QSR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Marc Caira
Director
Period of report
Oct 29, 2015
Accepted (ET)
Oct 30, 2015 · 5:35 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001618756
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Oct 29, 2015 | G | 11,328 | $0.00 | D | 17,241 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Appreciation RightF5,F2,F3,F4 | $21.60 | holding | — | — | — | — | — | Common Stock | 200,000 | 200,000 | D |
| Option (right to buy)F6 | $41.90 | holding | — | — | — | Mar 3, 2020 | Mar 6, 2025 | Common Stock | 17,747 | 17,747 | D |
Explanation of responses
- F1The Reporting Person transferred these shares as a gift in an exempt transaction pursuant to Rule 16b-5 of the Exchange Act.
- F2The options were issued with an exercise price of CAD$24.93. The reported exercise price represents the U.S. dollar equivalent following conversion using the Bank of Canada noon exchange rate of 0.8666.
- F3These options are vested and immediately exercisable.
- F4These options are exercisable until the earlier of (i) December 14, 2017 and (ii) 90 days after the cessation of the Reporting Person's service on the Restaurant Brands International Inc. Board of Directors.
- F5This figure includes the Reporting Person's holdings both of options and the tandem SARs.
- F6The options were issued with an exercise price of CAD$52.86. The reported exercise price represents the U.S. dollar equivalent following conversion using the Bank of Canada noon exchange rate of 0.7926.