Toggle SGML Header (+)


Section 1: 3 (FORM 3 SUBMISSION)

Ownership Submission
FORM 3
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF 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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden hours per response... 0.5

(Print or Type Responses)
1. Name and Address of Reporting Person *
  Siddiqui Sami A.
2. Date of Event Requiring Statement (Month/Day/Year)
10/13/2020
3. Issuer Name and Ticker or Trading Symbol
Restaurant Brands International Inc. [QSR]
(Last)
(First)
(Middle)
5707 BLUE LAGOON DRIVE
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
__X__ Officer (give title below) _____ Other (specify below)
Brand Pres., Popeyes, Americas
5. If Amendment, Date Original Filed (Month/Day/Year)
(Street)

MIAMI, FL 33126
6. Individual or Joint/Group Filing (Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
(City)
(State)
(Zip)
Table I - Non-Derivative Securities Beneficially Owned
1.Title of Security
(Instr. 4)
2. Amount of Securities Beneficially Owned
(Instr. 4)
3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
4. Nature of Indirect Beneficial Ownership
(Instr. 5)
Common Shares 48,275
D
 

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. SEC 1473 (7-02)
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.

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 4)
2. Date Exercisable and Expiration Date
(Month/Day/Year)
3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
4. Conversion or Exercise Price of Derivative Security 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
6. Nature of Indirect Beneficial Ownership
(Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Option (Right to Buy)   (1) 03/05/2025 Common Shares 4,318 $42.26 D  
Option (Right to Buy)   (1) 03/05/2025 Common Shares 114,045 $42.26 D  
Option (Right to Buy) 02/24/2022 02/23/2027 Common Shares 80,000 $55.55 D  
Option (Right to Buy) 02/21/2025 02/20/2030 Common Shares 20,000 $66.31 D  
Restricted Share Units   (2)   (2) Common Shares 11,880 (3) D  
Dividend Equivalent Rights   (4)   (4) Common Shares 1,532.362 (5) D  
Restricted Share Units   (6)   (6) Common Shares 7,771 (3) D  
Dividend Equivalent Rights   (7)   (7) Common Shares 876.7857 (5) D  
Restricted Share Units   (8)   (8) Common Shares 5,726 (3) D  
Dividend Equivalent Rights   (9)   (9) Common Shares 370.4167 (5) D  
Restricted Share Units   (10)   (10) Common Shares 7,163 (3) D  
Dividend Equivalent Rights   (11)   (11) Common Shares 241.5037 (5) D  
Performance Share Units 02/26/2021 02/26/2021 Common Shares 150,000 (12) D  
Dividend Equivalent Rights   (13)   (13) Common Shares 19,450.0195 (5) D  
Performance Share Units 02/22/2024 02/22/2024 Common Shares 50,000 (14) D  
Dividend Equivalent Rights   (15)   (15) Common Shares 3,234.5151 (5) D  
Performance Share Units 02/21/2025 02/21/2025 Common Shares 20,000 (16) D  
Dividend Equivalent Rights   (17)   (17) Common Shares 674.3089 (5) D  

Reporting Owners

Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Siddiqui Sami A.
5707 BLUE LAGOON DRIVE
MIAMI, FL 33126
      Brand Pres., Popeyes, Americas  

Signatures

/s/ Michele Keusch, as Attorney-in-Fact for Sami A. Siddiqui 10/23/2020
**Signature of Reporting Person Date

Explanation of Responses:

* If the form is filed by more than one reporting person, see Instruction 5(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) These options are immediately exercisable.
(2) These restricted share units vest on December 31, 2020.
(3) Each restricted share unit represents a contingent right to receive one common share.
(4) 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.
(5) Each whole dividend equivalent right represents a contingent right to receive one common share.
(6) These restricted share units vest on December 31, 2021.
(7) 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.
(8) These restricted share units vest on December 31, 2023.
(9) These dividend equivalent rights accrued on the 2019 restricted share unit award (the "2019 RSUs"). Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2019 RSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2019 RSUs to which they relate.
(10) These restricted share units vest on December 31, 2024.
(11) These dividend equivalent rights accrued on the 2020 restricted share unit award (the "2020 RSUs"). Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2020 RSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2020 RSUs to which they relate.
(12) The shares reported represent an award of performance based restricted share units (the "2016 PBRSUs") granted to the Reporting Person. The 2016 PBRSUs had a three-year performance period beginning January 1, 2015 and ending December 31, 2018 and will vest 100% on February 26, 2021, which is the fifth anniversary of the grant date.
(13) 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.
(14) 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 to the extent earned 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.
(15) These dividend equivalent rights accrued on the 2019 PBRSUs. Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2019 PBRSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2019 PBRSUs to which they relate.
(16) The shares reported represent an award of performance based restricted share units (the "2020 PBRSUs") granted to the Reporting Person. The 2020 PBRSUs will have a performance period beginning January 1, 2019 and ending December 31, 2022 and to the extent earned will vest 100% on February 21, 2025, which is the fifth anniversary of the grant date. The number of common shares that will be earned at the end of the performance period is subject to increase or decrease based on the results of the Issuer performance condition.
(17) These dividend equivalent rights accrued on the 2020 PBRSUs. Dividend equivalent rights accrue when and as dividends are paid on the common shares underlying the 2020 PBRSUs and vest proportionately with and are subject to settlement and expiration upon the same terms as the 2020 PBRSUs to which they relate.

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure.

Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. (Back To Top)