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