Statement of Changes in Beneficial Ownership (4)
July 27 2016 - 5:46PM
Edgar (US Regulatory)
FORM 4
[
X
]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
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
*
BEEM DANIEL L.
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2. Issuer Name
and
Ticker or Trading Symbol
KRISPY KREME DOUGHNUTS INC
[
KKD
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Senior Vice President
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(Last)
(First)
(Middle)
370 KNOLLWOOD STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
7/27/2016
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(Street)
WINSTON-SALEM, NC 27103
(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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Common Stock
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7/27/2016
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A
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10266
(1)
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A
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$0.00
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32442
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D
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Common Stock
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7/27/2016
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D
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32442
(2)
(3)
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D
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$21.00
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0
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Employee Stock Option (right to buy)
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(4)
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7/27/2016
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D
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19607
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(4)
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(4)
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Common Stock
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19607
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(4)
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0
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D
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Explanation of Responses:
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(
1)
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Represents performance-based restricted stock units granted to the Reporting Person on March 24, 2016, whose performance criteria remained subject to time-based vesting conditions immediately prior to consummation of the Merger and were deemed satisfied pursuant to the Agreement and Plan of Merger, dated as of May 8, 2016, by and among the Issuer, Cotton Parent, Inc., Cotton Merger Sub Inc. and JAB Holdings B.V. (the "Merger Agreement").
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(
2)
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2,953 shares disposed pursuant to the Merger Agreement, at the effective time of the Merger (as defined in the Merger Agreement), in exchange for $21.00 for each share of the Issuer's common stock held by the Reporting Person.
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(
3)
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29,489 unvested restricted stock units disposed pursuant to the Merger Agreement, in which, at the effective time of the Merger, each unvested restricted stock unit was cancelled and converted into the right to receive a cash payment equal to the product of (x) the number of shares of the Issuer's common stock subject to each share unit and (y) $21.00.
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(
4)
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19,607 stock options disposed pursuant to the Merger Agreement in which, at the effective time of the Merger, each outstanding stock option, whether vested or unvested, was cancelled and converted into the right to receive an amount in cash equal to the product of (i) the excess, if any, of (x) the merger consideration of $21.00 per share over (y) the exercise price per share of such option, and (ii) the number of shares underlying such option. The options were issued at varying exercise prices, exercisable dates and expiration dates.
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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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BEEM DANIEL L.
370 KNOLLWOOD STREET
WINSTON-SALEM, NC 27103
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Senior Vice President
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Signatures
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Kimberly Kennedy, Attorney-in-Fact
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7/27/2016
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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 4(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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