SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Melaragni Anne

(Last) (First) (Middle)
4221 WEST BOY SCOUT BOULEVARD

(Street)
TAMPA FL 33607

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
05/04/2021
3. Issuer Name and Ticker or Trading Symbol
Primo Water Corp /CN/ [ PRMW ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Human Resources Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Shares 5,416(1) D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy) (2) 08/24/2030 Common Shares 13,554 $14.3 D
Stock Option (right to buy) (3) 12/09/2030 Common Shares 11,817 $15.84 D
Explanation of Responses:
1. Represents (i) 427 shares acquired under the Issuer's Employee Stock Purchase Plan, (ii) 2,622 time-based restricted share units ("RSUs"), which are contingent rights to receive common shares, granted on August 24, 2020, and (iii) 2,367 RSUs granted on December 9, 2020. RSUs that have not been forfeited shall vest in equal one-third installments on each of the first, second and third anniversaries of their respective grant date.
2. Represents an option to purchase 13,554 common shares of Primo Water Corporation, granted on August 24, 2020. The option vests in equal one-third installments on each of the first, second and third anniversaries of the grant date.
3. Represents an option to purchase 11,817 common shares of Primo Water Corporation, granted on December 9, 2020. The option vests in equal one-third installments on each of the first, second and third anniversaries of the grant date.
Remarks:
Exhibit List Exhibit 24 - Power of Attorney
/s/ Marni Morgan Poe, Attorney-in-Fact 05/07/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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