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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
| Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) | ||
| 1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Exchangeable units (3) | (3) | (3) | (3) | Common Shares | 5,413 | 5,413 | D | ||||||||
| Option (right to buy) | $ 27.28 | (4) | 03/06/2024 | Common Shares | 32,991 | 32,991 | D | ||||||||
| Option (right to buy) | $ 27.28 | 03/07/2019 | 03/06/2024 | Common Shares | 300,000 | 300,000 | D | ||||||||
| Option (right to buy) | $ 42.26 | 12/31/2019 | 03/05/2025 | Common Shares | 35,494 | 35,494 | D | ||||||||
| Option (right to buy) | $ 42.26 | 03/06/2020 | 03/05/2025 | Common Shares | 300,000 | 300,000 | D | ||||||||
| Restricted Share Units | (5) | (6) | (6) | Common Shares | 26,730 | 26,730 | D | ||||||||
| Dividend Equivalent Rights | (7) | (8) | (8) | Common Shares | 1,614.2184 | 1,614.2184 | D | ||||||||
| Performance Share Units | (9) | 02/26/2021 | 02/26/2021 | Common Shares | 353,500 | 353,500 (10) | D | ||||||||
| Dividend Equivalent Rights | (11) | (12) | (12) | Common Shares | 21,316.018 | 21,316.018 (10) | D | ||||||||
| Restricted Share Units | (5) | (13) | (13) | Common Shares | 20,114 | 20,114 | D | ||||||||
| Dividend Equivalent Rights | (7) | (14) | (14) | Common Shares | 909.4099 | 909.4099 | D | ||||||||
| Option (right to buy) | $ 56.92 | 05/05/2022 | 05/04/2027 | Common Shares | 200,000 | 200,000 | D | ||||||||
| Restricted Share Units | (5) | (15) | (15) | Common Shares | 17,111 | 17,111 | D | ||||||||
| Dividend Equivalent Rights | (7) | (16) | (16) | Common Shares | 547.2384 | 547.2384 | D | ||||||||
| Restricted Share Units | (5) | 02/22/2019 | A | 13,313 (17) | (18) | (18) | Common Shares | 13,313 | $ 0 | 13,313 | D | ||||
| Performance Share Units | (19) | 02/22/2019 | A | 225,000 | 02/22/2024 | 02/22/2024 | Common Shares | 225,000 | $ 0 | 225,000 | D | ||||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Kobza Joshua 130 KING STREET WEST SUITE 300 TORONTO, A6 M5X 1E1 |
COO | |||
| /s/ Lisa Giles-Klein, As Attorney-in-Fact for Joshua Kobza | 02/26/2019 | |
| **Signature of Reporting Person | Date |
| * | If the form is filed by more than one reporting person, see Instruction 4(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). |
| (1) | The shares reported represent common shares purchased from the Issuer by the Reporting Person upon exercise of his investment rights pursuant to the Issuer's 2018 Bonus Swap Program under its Amended and Restated 2014 Omnibus Incentive Plan ("2014 Plan"). The Reporting Person elected to use 50% of his 2018 net bonus to purchase common shares at a purchase price of $64.75 per share ("Investment Shares"). |
| (2) | Pursuant to the Issuer's 2014 Plan, the purchase price of the Investment Shares is, and the number of matching restricted share units described in footnote 18 below pursuant to the Issuer's 2018 Bonus Swap Program is calculated based on, the last sales price of a common share of the Issuer on the New York Stock Exchange on the trading day immediately preceding the grant date, in this case February 21, 2019. |
| (3) | Each Restaurant Brands International Limited Partnership exchangeable unit is convertible, at the Reporting Person's election, into common shares of Restaurant Brands International Inc. or a cash amount equal to a prescribed cash amount determined by reference to the weighted average trading price of Restaurant Brands International Inc.'s common shares on the New York Stock Exchange for the 20 consecutive trading days ending on the last business day prior to the exchange date, at the sole discretion of the general partner of Restaurant Brands International Limited Partnership (subject to the consent of the Restaurant Brands International Inc. conflicts committee, in certain circumstances). This conversion right has no expiration date. |
| (4) | These options are immediately exerciseable. |
| (5) | Each restricted share unit represents a contingent right to receive one common share. |
| (6) | These restricted share units vest on December 31, 2020. |
| (7) | Each whole dividend equivalent right represents a contingent right to receive one common share. |
| (8) | These dividend equivalent rights accrued on the 2016 restricted share unit award (the "2016 RSUs"). Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2016 RSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2016 RSUs to which they relate. |
| (9) | The shares reported represent an award of performance based restricted share units (the "2016 PBRSUs") granted to the Reporting Person. The 2016 PBRSUs will have a three-year performance period beginning January 1, 2015 and ending December 31, 2018 and will vest 100% on February 24, 2021, which is the fifth anniversary of the grant date. The number of common shares that will be earned at the end of the three-year performance period is subject to increase or decrease based on the results of the Issuer performance condition. |
| (10) | The amount of dividend equivalent rights accrued on the 2016 PBRSUs included an amount of 3,500, which should have been reflected as 2016 PBRSUs rather than dividend equivalent rights. The amounts have been revised to reflect the correct allocation between the amount of 2016 PBRSUs and the dividend equivalent rights accrued thereon. |
| (11) | Each whole dividend equivalent right represents a contingent right to receive one common share, subject to increase or decrease based on the results of the Issuer performance condition. |
| (12) | These dividend equivalent rights accrued on the 2016 PBRSUs. Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2016 PBRSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2016 PBRSUs to which they relate. |
| (13) | These restricted share units vest on December 31, 2021. |
| (14) | These dividend equivalent rights accrued on the 2017 restricted share unit award (the "2017 RSUs"). Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2017 RSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2017 RSUs to which they relate. |
| (15) | These restricted share units vest on December 31, 2022. |
| (16) | These dividend equivalent rights accrued on the 2018 restricted share unit award (the "2018 RSUs"). Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2018 RSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2018 RSUs to which they relate. |
| (17) | The Issuer granted the 2019 restricted share units ("2019 RSUs") to the Reporting Person pursuant to the Issuer's 2018 Bonus Swap Program under its 2014 Plan. The Reporting Person elected to use 50% of his 2018 net bonus to purchase Investment Shares and received a matching grant of 2019 RSUs in an amount equal to 50% of his gross bonus, multiplied by a multiple based on the Reporting Person's position level with the Issuer ("RSU Multiplier"), and divided by the purchase price of $64.75 per share. The RSU Multiplier was 2.0 for executive vice presidents and above. If the Reporting Person sells 50% or less of the Investment Shares, he will forfeit 6,656 of the 2019 RSUs and a proportionate number of the remaining 2019 RSUs based on the number of Investment Shares sold. If the Reporting Person sells more than 50% of the Investment Shares, he will forfeit all of the 2019 RSUs. |
| (18) | These restricted share units vest on December 31, 2023. |
| (19) | The shares reported represent an award of performance based restricted share units ("2019 PBRSUs") granted to the Reporting Person. The 2019 PBRSUs will have a three-year performance period beginning January 1, 2019 and ending December 31, 2022 and will vest 100% on February 22, 2024, which is the fifth anniversary of the grant date. The number of common shares that will be earned at the end of the three-year performance period is subject to increase or decrease based on the results of the Issuer performance condition. |