Statement of Changes in Beneficial Ownership (4)
March 05 2021 - 4:24PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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3235-0287
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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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Pleuhs Gerhard W. |
2. Issuer Name and Ticker or Trading Symbol
Keurig Dr Pepper Inc.
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KDP
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner _____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
53 SOUTH AVE. |
3. Date of Earliest Transaction
(MM/DD/YYYY)
3/3/2021 |
(Street)
BURLINGTON, MA 01803
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security (Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code (Instr. 8)
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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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. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. 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 | 7. Title and Amount of Securities Underlying Derivative Security (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) |
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Restricted Stock Units | (1) | 3/3/2021 | | A | | 5226 | | (1) | (1) | Common Stock | 5226 | $0.00 | 5226 (2) | D | |
Explanation of Responses: |
(1) | Subject to certain vesting conditions and exceptions, these restricted stock units vest on March 3, 2026. Each restricted stock unit represents a contingent right to receive one share of the Issuer's Common Stock upon vesting. |
(2) | The Reporting Person is an officer of Mondelez International, Inc. (Mondelez International) and serves on the Board of Directors of the Issuer as a nominee of Mondelez International, a stockholder of the Issuer. The Reporting Person has agreed that he will not receive any separate compensation for serving on the Board of Directors of the Issuer and will transfer to Mondelez International any director compensation he receives from the Issuer, including any awards made pursuant to grants of restricted stock units. The Reporting Person disclaims beneficial ownership of such restricted stock units except to the extent of his pecuniary interests therein and this report shall not be deemed that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or any other purpose. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Pleuhs Gerhard W. 53 SOUTH AVE. BURLINGTON, MA 01803 | X |
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Signatures
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/s/ Anthony Shoemaker, attorney in fact | | 3/5/2021 |
**Signature of Reporting Person | Date |
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