0001209191-17-052038.txt : 20170908
0001209191-17-052038.hdr.sgml : 20170908
20170908161115
ACCESSION NUMBER: 0001209191-17-052038
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170907
FILED AS OF DATE: 20170908
DATE AS OF CHANGE: 20170908
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MCQUILKIN MALCOLM
CENTRAL INDEX KEY: 0001247260
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34850
FILM NUMBER: 171076697
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
2017-09-07
0
0001365101
Primo Water Corp
PRMW
0001247260
MCQUILKIN MALCOLM
101 NORTH CHERRY STREET
SUITE 501
WINSTON-SALEM
NC
27101
1
0
0
0
Common Stock
2017-09-07
4
X
0
57143
2.30
A
126042
D
Common Stock
2017-09-07
4
S
0
11082
11.86
D
114960
D
Common Stock
313607
I
See Footnote
Warrant (right to buy)
2.30
2017-09-07
4
X
0
57143
0.00
D
2012-04-30
2020-04-30
Common Stock
57143
0
D
On September 7, 2017, the reporting person exercised a warrant to purchase 57,143 shares of the Issuer's common stock for $2.30 per share. The reporting person paid the exercise price on a cashless basis, resulting in the Issuer's (i) withholding of 11,082 of the warrant shares to pay the exercise price and (ii) issuing to the reporting person the remaining 46,061 shares.
Held by Malcolm McQuilkin Living Trust of which Malcolm McQuilkin is a co-trustee.
/s/ David J. Mills by power of attorney for Malcolm McQuilkin
2017-09-08