Initial Statement of Beneficial Ownership (3)
June 30 2017 - 8:43AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
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0.5
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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
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Alt Jaxie S Inc.
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/26/2017
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3. Issuer Name
and
Ticker or Trading Symbol
Dr Pepper Snapple Group, Inc. [DPS]
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(Last)
(First)
(Middle)
5301 LEGACY DRIVE
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Executive Vice President /
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(Street)
PLANO, TX
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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3283
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Restricted Stock Units
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(1)
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(1)
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Common Stock
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909
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(2)
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D
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Restricted Stock Units
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(3)
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(3)
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Common Stock
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826
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(2)
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D
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Restricted Stock Units
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(4)
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(4)
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Common Stock
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887
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(2)
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D
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Performance Stock Units
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(5)
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(5)
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Common Stock
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678
(5)
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(2)
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D
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Employee Stock Option (Right to Buy)
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(6)
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3/3/2024
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Common Stock
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1954
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$51.68
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D
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Employee Stock Option (Right to Buy)
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(7)
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3/2/2025
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Common Stock
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2602
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$79.20
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D
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Employee Stock Option (Right to Buy)
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(8)
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3/2/2026
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Common Stock
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3828
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$91.98
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D
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Employee Stock Option (Right to Buy)
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(9)
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3/2/2028
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Common Stock
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4221
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$94.62
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D
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Explanation of Responses:
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(1)
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These shares represent restricted stock units granted on March 2, 2015 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009 and vest in one installment three years from the date of grant and will be settled in shares of the Issuer's Common Stock on the vesting date.
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(2)
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Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock and is granted pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009.
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(3)
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These shares represent the unvested portion of restricted stock units granted on March 2, 2016 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009 and vest in two equal installments on March 2, 2018 and March 2, 2019 and will be settled in shares of the Issuer's Common Stock on the vesting date.
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(4)
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These shares represent restricted stock units granted on March 2, 2017 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009 and vest in three equal installments on March 4, 2018, March 4, 2019 and March 4, 2020, and will be settled in shares of the Issuer's Common Stock on the vesting date.
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(5)
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These performance stock units ("PSU") were granted on September 1, 2015. The performance period has ended and the amount indicated reflects the number of PSU's earned during the performance period. The shares will vest on September 1, 2018.
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(6)
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This represents the unvested and unexercised options granted on March 3, 2014 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009. All of these options are fully vested.
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(7)
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This option represents the unvested and unexercised options granted on March 2, 2015 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009. 1,301 of these options are fully vested and the remaining 1,301 options will vest on March 2, 2018
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(8)
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This option represents the unvested and uexercised options granted on March 2, 2016 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009. 1,276 of these options are fully vested and the remaining 2,552 shares vest in equal installments on March 2, 2018 and March 2, 2019.
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(9)
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This option represents the unvested and unexercised options granted on March 2, 2017 pursuant to the Issuer's Omnibus Stock Incentive Plan of 2009 and vests in three equal annual installments commencing on March 4, 2018, March 4, 2019 and March 4, 2020.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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Alt Jaxie S Inc.
5301 LEGACY DRIVE
PLANO, TX
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Executive Vice President
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Signatures
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Wayne R. Lewis, attorney in fact
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6/30/2017
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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