0001209191-18-003444.txt : 20180112 0001209191-18-003444.hdr.sgml : 20180112 20180112164253 ACCESSION NUMBER: 0001209191-18-003444 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180110 FILED AS OF DATE: 20180112 DATE AS OF CHANGE: 20180112 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: 18526352 MAIL ADDRESS: STREET 1: 101 NORTH CHERRY STREET STREET 2: SUITE 501 CITY: WINSTON SALEM STATE: NC ZIP: 27101 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 2018-01-10 0 0001365101 Primo Water Corp PRMW 0001078296 PRIM BILLY D 101 NORTH CHERRY STREET SUITE 501 WINSTON-SALEM NC 27101 1 1 0 0 Executive Chairman Common Stock 2018-01-10 4 M 0 174528 0.00 A 1530455 D Common Stock 2018-01-10 4 M 0 79519 0.00 A 1609974 D Common Stock 2018-01-10 4 F 0 117693 0.00 D 1492281 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 Deferred Stock Units 2018-01-10 4 M 0 174528 0.00 D Common Stock 174528 698114 D Deferred Stock Units 2018-01-10 4 M 0 79519 0.00 D Common Stock 79519 318080 D Represents shares of common stock received upon vesting of deferred stock units on January 10, 2018. Shares withheld to satisfy tax withholding requirements on the vesting of deferred stock units on January 10, 2018. 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 Gralyn 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. Each deferred stock unit has a value as of a given date equal to the fair market value of one share of Primo Water Corporation common stock. 174,528 deferred stock units were delivered on January 10, 2018. The remaining 698,114 deferred stock units are to be delivered in equal annual installments in January of each of 2019, 2020, 2021 and 2022. 79,519 deferred stock units were delivered on January 10, 2018. The remaining 318,080 deferred stock units are to be delivered in equal annual installments in January of each of 2019, 2020, 2021 and 2022. /s/ David J. Mills by power of attorney for Billy D. Prim 2018-01-12