0001181431-11-060740.txt : 20111216
0001181431-11-060740.hdr.sgml : 20111216
20111216092132
ACCESSION NUMBER: 0001181431-11-060740
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111214
FILED AS OF DATE: 20111216
DATE AS OF CHANGE: 20111216
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: 104 CAMBRIDGE PLAZA DRIVE
CITY: Winston Salem
STATE: NC
ZIP: 27104
BUSINESS PHONE: 336-331-4000
MAIL ADDRESS:
STREET 1: 104 CAMBRIDGE PLAZA DRIVE
CITY: Winston Salem
STATE: NC
ZIP: 27104
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PRIM BILLY D
CENTRAL INDEX KEY: 0001078296
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34850
FILM NUMBER: 111264951
MAIL ADDRESS:
STREET 1: 104 CAMBRIDGE PLAZA DRIVE
CITY: WINSTON SALEM
STATE: NC
ZIP: 27104
4
1
rrd328327.xml
PRIM FORM 4
X0304
4
2011-12-14
0
0001365101
Primo Water Corp
PRMW
0001078296
PRIM BILLY D
104 CAMBRIDGE PLAZA DRIVE
WINSTON-SALEM
NC
27104
1
1
1
0
Chairman, CEO and President
Common Stock
2011-12-14
4
P
0
20000
2.99
A
2297056
D
Common Stock
8032
I
See Footnote
Common Stock
4791
I
See Footnote
Common Stock
4791
I
See Footnote
Common Stock
23957
I
See Footnote
Common Stock
23957
I
See Footnote
Common Stock
4791
I
See Footnote
Common Stock
4791
I
See Footnote
20,000 of these shares are restricted stock units which may only be settled in stock and which vest in equal annual installments on March 29 of each of 2012, 2013 and 2014.
Held by Mr. Prim's spouse.
Held by Billy D. Prim Revocable Trust of which Mr. Prim is the sole trustee.
Held by BD Prim, LLC of which Mr. Prim is the sole manager.
Held by 2010 Irrevocable Trust fbo Sarcanda Westmoreland Bellisimo of which Mr. Prim is the sole trustee.
Held by 2010 Irrevocable Trust fbo Anthony Gray Westmoreland of which Mr. Prim is the sole trustee.
Held by 2010 Irrevocable Trust fbo Jager Grayln Dean Bellisimo of which Mr. Prim is the sole trustee.
Held by 2010 Irrevocable Trust fbo Joseph Alexander Bellisimo of which Mr. Prim is the sole trustee.
/s/ Patrick J. Rogers by power of attorney for Billy D. Prim
2011-12-16