SEC Form 4 · accession 0001209191-17-000158
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 30, 2016
Accepted (ET)
Jan 3, 2017 · 3:54 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 | Dec 30, 2016 | A | 2,504 | $0.00 | A | 25,735 | 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 Shares | 11,831 | 11,831 | D |
Explanation of responses
- F1Represents restricted stock units that are earned and vested upon grant and that settle upon termination of board service.
- F2The options were issued with an exercise price of CAD$52.86. The reported exercise price represents the U.S. dollar equivalent.