SEC Form 4 · accession 0001209191-15-079442

Restaurant Brands International Inc. · QSR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Nov 9, 2015

Accepted (ET)

Nov 10, 2015 · 7:45 pm EST

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^F1,F2	Nov 9, 2015	P	82,544	$35.29	A	82,544	I	See Footnote
Common Stock^F3,F2	Nov 9, 2015	P	113,456	$35.76	A	196,000	I	See Footnote
Common Stock	holding	—	—		—	47,695	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Option (right to buy)^F4	$3.54	holding	—	—	—	—	Feb 2, 2021	Common Stock	106,050	106,050	D

F1Represents the weighted average priced of the shares acquired. The prices of the shares acquired pursuant to the transactions ranged from $35.13 to $35.49 per share. The Reporting Person, upon request, will provide the Securities and Exchange Commission staff, the issuer or a security holder of the issuer full information regarding the number of shares purchased at each separate price.
F2Represents an indirect interest held by Lobstertail Corporation. The Reporting Person is an indirect beneficial owner of equity interests in Lobstertail Corporation. The Reporting Person disclaims beneficial ownership of any shares in which he does not have a pecuniary interest.
F3Represents the weighted average price of the shares acquired. The prices of shares acquired pursuant to the transactions ranged from $35.50 to $36.30 per share. The Reporting Person, upon request, will provide the Securities and Exchange Commission staff, the issuer or a security holder of the issuer full information regarding the number of shares purchased at each separate price.
F4These options are immediately exercisable.