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