SEC Form 4 · accession 0001209191-16-100863
Restaurant Brands International Inc. · QSR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Alexandre Van Damme
Director
Period of report
Feb 19, 2016
Accepted (ET)
Feb 22, 2016 · 3:28 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 | Feb 19, 2016 | P | 78,125 | $32.74 | A | 5,278,125 | I | See Footnote |
| Common Shares | holding | — | — | — | 16,978 | 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) | $3.98 | holding | — | — | — | Mar 1, 2017 | Feb 28, 2022 | Common Shares | 141,105 | 141,105 | D |
Explanation of responses
- F1Represents the weighted average priced of the shares acquired. The prices of the shares acquired pursuant to the transactions ranged from $32.45 to $33.15 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 Societe Familiale d'Investissements. The Reporting Person is an indirect beneficial owner of equity interests in Societe Familiale d'Investissements. The Reporting Person disclaims beneficial ownership of any shares in which he does not have a pecuniary interest.