0001345471-12-000103.txt : 20121114 0001345471-12-000103.hdr.sgml : 20121114 20121114164753 ACCESSION NUMBER: 0001345471-12-000103 CONFORMED SUBMISSION TYPE: 13F-NT PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20120930 FILED AS OF DATE: 20121114 DATE AS OF CHANGE: 20121114 EFFECTIVENESS DATE: 20121114 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PELTZ NELSON CENTRAL INDEX KEY: 0000928265 FILING VALUES: FORM TYPE: 13F-NT SEC ACT: 1934 Act SEC FILE NUMBER: 028-11639 FILM NUMBER: 121205448 MAIL ADDRESS: STREET 1: 280 PARK AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 FORMER COMPANY: FORMER CONFORMED NAME: NELSON PELTZ DATE OF NAME CHANGE: 19940810 13F-NT 1 np.txt NELSON PELTZ, SEPTEMBER 30, 2012 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 13F FORM 13F COVER PAGE Report for the Calendar Year or Quarter Ended: September 30, 2012 ------------------------ Check here if Amendment [ ]; Amendment Number: ------- This Amendment (Check only one.): [ ] is a restatement. [ ] adds new holdings entries. Institutional Investment Manager Filing this Report: Name: Nelson Peltz -------------------------------------------------- Address: 280 Park Avenue, 41st Floor -------------------------------------------------- New York, New York 10017 -------------------------------------------------- -------------------------------------------------- Form 13F File Number: 28-11639 -------- The institutional investment manager filing this report and the person by whom it is signed hereby represent that the person signing the report is authorized to submit it, that all information contained herein is true, correct and complete, and that it is understood that all required items, statements, schedules, lists, and tables, are considered integral parts of this form. Person Signing this Report on Behalf of Reporting Manager: Name: Nelson Peltz -------------------------------------------------- Title: -------------------------------------------------- Phone: 212-451-3000 -------------------------------------------------- Signature, Place, and Date of Signing: /s/NELSON PELTZ New York, New York 11/14/12 ------------------------ ------------------------------ -------- [Signature] [City, State] [Date] Report Type (Check only one.): [ ] 13F HOLDINGS REPORT. (Check here if all holdings of this reporting manager are reported in this report.) [ X ] 13F NOTICE. (Check here if no holdings reported are in this report, and all holdings are reported by other reporting manager(s).) [ ] 13F COMBINATION REPORT. (Check here if a portion of the holdings for this reporting manager are reported in this report and a portion are reported by other reporting manager(s).) List of Other Managers Reporting for this Manager: Form 13F File Number Name -------------------- ---- 28-12039 Trian Fund Management, L.P.