SEC Form 4 · accession 0001209191-18-001281

Restaurant Brands International Inc. · QSR

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

Reporting owner

Director

Period of report

Dec 30, 2017

Accepted (ET)

Jan 3, 2018 · 6:22 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 Shares^F1	Dec 30, 2017	A	1,951	$0.00	A	21,433	D
Common Shares^F2	holding	—	—		—	5,419,230	I	See Footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Exchangeable units^F3,F2	—	holding	—	—	—	—	—	Common Shares	2,858,895	2,858,895	I

F1Represents restricted stock units that are earned and vested upon grant and that settle upon termination of board service.
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.
F3Each Restaurant Brands International Limited Partnership exchangeable unit is convertible, at the Reporting Person's election, into common shares of Restaurant Brands International Inc. or a cash amount equal to a prescribed cash amount determined by reference to the weighted average trading price of Restaurant Brands International Inc.'s common shares on the New York Stock Exchange for the 20 consecutive trading days ending on the last business day prior to the exchange date, at the sole discretion of the general partner of Restaurant Brands International Limited Partnership (subject to the consent of the Restaurant Brands International Inc. conflicts committee, in certain circumstances). This conversion right has no expiration date.