SEC Form 4 · accession 0001209191-16-088083
Restaurant Brands International Inc. · QSR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Marc Caira
Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 4, 2016 · 8:20 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 SharesF1,F2 | Dec 31, 2015 | A | 4,039 | $0.00 | A | 21,513 | 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 RightF6,F3,F4,F5 | $21.60 | holding | — | — | — | — | — | Common Shares | 200,000 | 200,000 | D |
| Option (right to buy)F7 | $41.90 | holding | — | — | — | Mar 3, 2020 | Mar 6, 2025 | Common Shares | 17,747 | 17,747 | D |
Explanation of responses
- F1Represents restricted stock units that are earned and vested upon grant and that settle upon termination of board service.
- F2Includes 233 shares acquired pursuant to a dividend reinvestment plan.
- F3The 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.
- F4These options are vested and immediately exercisable.
- F5These 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.
- F6This figure includes the Reporting Person's holdings both of options and the tandem SARs.
- F7The 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.