0001209191-18-003442.txt : 20180112 0001209191-18-003442.hdr.sgml : 20180112 20180112163948 ACCESSION NUMBER: 0001209191-18-003442 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180110 FILED AS OF DATE: 20180112 DATE AS OF CHANGE: 20180112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Hass David W. CENTRAL INDEX KEY: 0001706875 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34850 FILM NUMBER: 18526334 MAIL ADDRESS: STREET 1: 101 NORTH CHERRY STREET, SUITE 501 CITY: WINSTON-SALEM STATE: NC ZIP: 27101 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Primo Water Corp CENTRAL INDEX KEY: 0001365101 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-GROCERIES & GENERAL LINE [5141] IRS NUMBER: 300278688 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 101 NORTH CHERRY STREET STREET 2: SUITE 501 CITY: WINSTON-SALEM STATE: NC ZIP: 27101 BUSINESS PHONE: 336-331-4000 MAIL ADDRESS: STREET 1: 101 NORTH CHERRY STREET STREET 2: SUITE 501 CITY: WINSTON-SALEM STATE: NC ZIP: 27101 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2018-01-10 0 0001365101 Primo Water Corp PRMW 0001706875 Hass David W. 101 NORTH CHERRY STREET, SUITE 501 WINSTON-SALEM NC 27101 0 1 0 0 Chief Strategy Officer Common Stock 2017-12-31 5 A 0 E 643 10.44 A 80888 D Common Stock 2018-01-10 4 M 0 29095 0.00 A 109983 D Common Stock 2018-01-10 4 M 0 16620 0.00 A 126603 D Common Stock 2018-01-10 4 F 0 20472 0.00 D 106131 D Common Stock 4750 I See Footnote Common Stock 16401 I See Footnote Deferred Stock Units 2018-01-10 4 M 0 29095 0.00 D Common Stock 29095 87286 D Deferred Stock Units 2018-01-10 4 M 0 16620 0.00 D Common Stock 16620 49860 D These shares were acquired under the Primo Water Corporation Employee Stock Purchase Plan, as amended, in transactions that were exempt under both Rule 16b-3(d) and Rule 16b-3(c). Represents shares of common stock received upon vesting of deferred stock units on January 10, 2018. Shares withheld to satisfy tax withholding requirements on the vesting of deferred stock units on January 10, 2018. These shares of common stock are owned by HB Capital LLC, of which David Hass is a member. Mr. Hass may be deemed an indirect beneficial owner of the securities held directly by HB Capital LLC. Mr. Hass disclaims beneficial ownership of the securities held directly by HB Capital LLC, except to the extent of his pecuniary interest therein. Held by David W. Hass Living Trust, of which David Hass is a trustee. Each deferred stock unit has a value as of a given date equal to the fair market value of one share of Primo Water Corporation common stock. 29,095 deferred stock units were delivered on January 10, 2018. The remaining 87,286 deferred stock units are to be delivered in equal annual installments in January of each of 2019, 2020 and 2021. 16,620 deferred stock units were delivered on January 10, 2018. The remaining 49,860 deferred stock units are to be delivered in equal annual installments in January of each of 2019, 2020 and 2021. /s/ David J. Mills by power of attorney for David W. Hass 2018-01-12