0001209191-19-005415.txt : 20190125 0001209191-19-005415.hdr.sgml : 20190125 20190125175848 ACCESSION NUMBER: 0001209191-19-005415 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190123 FILED AS OF DATE: 20190125 DATE AS OF CHANGE: 20190125 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: 19543478 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 2019-01-23 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 2018-06-29 5 A 0 E 1186 10.68 A 111493 D Common Stock 2018-12-31 5 A 0 E 802 10.68 A 112295 D Common Stock 2019-01-23 4 M 0 29095 0.00 A 141390 D Common Stock 2019-01-23 4 M 0 16620 0.00 A 158010 D Common Stock 2019-01-23 4 F 0 19165 13.88 D 138845 D Common Stock 16901 I See Footnote Common Stock 5250 I See Footnote Deferred Stock Units 2019-01-23 4 M 0 29095 0.00 D Common Stock 29095 58191 D Deferred Stock Units 2019-01-23 4 M 0 16620 0.00 D Common Stock 16620 33240 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(c) and Rule 16b-3(d). Represents shares of common stock received upon vesting of deferred stock units on January 23, 2019. Shares withheld to satisfy tax withholding requirements on the vesting of deferred stock units on January 23, 2019. Held by David W. Hass Living Trust, of which David Hass is a trustee. 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. 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 23, 2019. The remaining 58,191 deferred stock units are to be delivered in equal annual installments in January of each of 2020 and 2021. 16,620 deferred stock units were delivered on January 23, 2019. The remaining 33,240 deferred stock units are to be delivered in equal annual installments in January of each of 2020 and 2021. /s/ David W. Hass by Michael H. Hutson, attorney-in-fact 2019-01-25