SEC Form 4 · accession 0001209191-15-086188
Restaurant Brands International Inc. · QSR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
V Milroy Thomas
Director
Period of report
Dec 16, 2015
Accepted (ET)
Dec 18, 2015 · 6:18 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 StockF1 | Dec 16, 2015 | P | 10,000 | $36.52 | A | 20,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option (Right to Buy)F2 | $41.90 | holding | — | — | — | Mar 6, 2020 | Mar 6, 2025 | Common Stock | 11,831 | 11,831 | D |
Explanation of responses
- F1Represents the weighted average price of the shares purchased and is reported in U.S. dollars. The reported shares were purchased in Canadian dollars at prices ranging from CAD$50.33 to CAD$50.50 per share, inclusive. The purchase prices were converted into their U.S. dollar equivalents ranging from USD$36.46 to USD$36.58 per share using the Bank of Canada noon exchange rate on December 16, 2015 of 0.7244. 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.
- F2The 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 on March 6, 2015 of 0.7926.