0001209191-21-023471.txt : 20210329 0001209191-21-023471.hdr.sgml : 20210329 20210329182901 ACCESSION NUMBER: 0001209191-21-023471 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210325 FILED AS OF DATE: 20210329 DATE AS OF CHANGE: 20210329 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SEIFFER JONATHAN A CENTRAL INDEX KEY: 0001243592 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32349 FILM NUMBER: 21782962 MAIL ADDRESS: STREET 1: 11111SANTA MONICA BLVD STREET 2: STE 2000 CITY: LOS ANGELES STATE: CA ZIP: 90025 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: SIGNET JEWELERS LTD CENTRAL INDEX KEY: 0000832988 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-JEWELRY STORES [5944] IRS NUMBER: 000000000 FISCAL YEAR END: 0201 BUSINESS ADDRESS: STREET 1: CLARENDON HOUSE STREET 2: 2 CHURCH STREET CITY: HAMILTON STATE: D0 ZIP: HM11 BUSINESS PHONE: 44-207-317-9700 MAIL ADDRESS: STREET 1: C/O 15 GOLDEN SQUARE CITY: LONDON STATE: X0 ZIP: W1F9JG FORMER COMPANY: FORMER CONFORMED NAME: SIGNET GROUP PLC DATE OF NAME CHANGE: 19931213 FORMER COMPANY: FORMER CONFORMED NAME: RATNERS GROUP PLC DATE OF NAME CHANGE: 19931213 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-03-25 0 0000832988 SIGNET JEWELERS LTD SIG 0001243592 SEIFFER JONATHAN A 11111 SANTA MONICA BOULEVARD SUITE 2000 LOS ANGELES CA 90025 1 0 1 0 Common Shares, par value $0.18 2020-03-25 4 A 0 235 0.00 A 15900 D Series A Convertible Preference Shares 81.7682 Common Shares 8032923 625000 I See footnote. Represents shares of Common Stock of the Issuer ("Common Shares") granted to Mr. Jonathan A. Seiffer on March 25, 2021 in lieu of his quarterly board retainer fees that were temporarily reduced in response to the financial impact of the COVID-19 pandemic. Such Common Shares were issued in accordance with the Signet Jewelers Limited 2018 Omnibus Incentive Plan and were fully vested on the date of issuance. The Common Shares are held by Mr. Seiffer for the benefit of Leonard Green & Partners, L.P. ("LGP"). Represents Common Shares owned by Mr. Seiffer and held for the benefit of LGP, and includes 5,952 restricted stock units, which are subject to certain vesting and forfeiture provisions. The Series A Preference Shares have a stated value of $1,050.94 per share and are convertible into Common Shares of the issuer at a current conversion price of $81.7682 per share at a conversion ratio of 12.2297 Common Shares per Series A Preference Share. The conversion ratio is subject to certain anti-dilution and other adjustments and is subject to change. Since the acquisition of the Series A Preference Shares, the conversion rate has been adjusted as a result of these anti-dilution adjustments. Immediately. The Series A Preference Shares do not have an expiration date. Green 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. Of the shares reported on this row, GEI VI is the direct owner of 387,522 Series A Preference Shares which are convertible into 4,980,696 Common Shares, GEI Side VI is the direct owner of 230,963 Series A Preference Shares which are convertible into 2,968,493 Common Shares, Associates VI-A is the direct owner of 470 Series A Preference Shares which are convertible into 6,040 Common Shares, and Associates VI-B is the direct owner of 6,045 Series A Preference Shares which are convertible into 77,694 Common Shares. Mr. Seiffer 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. Seiffer 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. /s/ Andrew Goldberg, as attorney in fact 2021-03-29