SEC Form 4 · accession 0001209191-16-145443
SIGNET JEWELERS LTD · SIG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jonathan D Sokoloff
Director
Period of report
Oct 5, 2016
Accepted (ET)
Oct 7, 2016 · 6:06 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000832988
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Shares, par value $0.18F1 | Oct 5, 2016 | A | 1,290 | $0.00 | A | 1,290 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Convertible Preference SharesF2,F6,F3,F4,F5 | $93.8712 | holding | — | — | — | — | — | Common Shares | 6,658,059 | 6,658,059 | I |
Explanation of responses
- F1Granted as compensation for services.
- F2Series A Convertible Preference Shares, par value $0.01 per share ("Series A Preference Shares").
- F3The Series A Preference Shares were acquired for $1,000.00 per share and are convertible into Common Shares of the issuer at a conversion price of $93.8712 per share at a conversion ratio of 10.6529 Common Shares per Series A Preference Share. The conversion ratio is subject to certain anti-dilution and other adjustments.
- F4Immediately.
- F5The Series A Preference Shares do not have an expiration date.
- F6Green Equity Investors VI, L.P. ("GEI VI"), Green Equity Investors Side VI, L.P. ("GEI Side VI"), LGP Associates VI-A LLC ("Associates VI-A") and LGP Associates VI-B LLC ("Associates VI-B") are the direct owners of the shares reported herein. Mr. Sokoloff directly (whether through ownership or position) or indirectly through one or more intermediaries, may be deemed for purposes of Section 16 of the Securities Exchange Act of 1934, as amended, to be the indirect beneficial owner of the shares owned by GEI VI, GEI Side VI, Associates VI-A and Associates VI-B. Mr. Sokoloff disclaims beneficial ownership of the shares reported herein except to the extent of his pecuniary interest therein and this report shall not be deemed an admission that he is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.