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