Sec Form 4/A Filing - Cortes Fernando @ Keurig Dr Pepper Inc. - 2018-07-09

Insider filing report for Changes in Beneficial Ownership
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FORM 4/A
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
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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1. Name and Address of Reporting Person
Cortes Fernando
2. Issuer Name and Ticker or Trading Symbol
Keurig Dr Pepper Inc. [ KDP]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Supply Chain Officer
(Last) (First) (Middle)
5301 LEGACY DRIVE
3. Date of Earliest Transaction (MM/DD/YY)
07/09/2018
(Street)
PLANO, TX75024
4. If Amendment, Date Original Filed (MM/DD/YY)
07/10/2018
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 Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 07/09/2018( 1 ) J 0 ( 2 ) A $ 0 12,461 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 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
(MM/DD/YY)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) $ 14.81 ( 3 ) 07/09/2018 M( 3 ) 37,538 ( 3 ) 07/09/2018 03/02/2026 Common Stock 37,538 ( 3 ) $ 0 37,538 ( 3 ) D
Employee Stock Option (Right to Buy) $ 15.23 ( 4 ) 07/09/2018 M( 4 ) 37,452 ( 4 ) 07/09/2018 03/02/2027 Common Stock 37,542 ( 4 ) $ 0 37,542 ( 4 ) D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Cortes Fernando
5301 LEGACY DRIVE
PLANO, TX75024
Chief Supply Chain Officer
Signatures
Kristin E. Blazewicz, attorney in fact 02/01/2019
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Pursuant to the Agreement and Plan of Merger, dated January 29, 2018, ("Agreement"), between Maple Parent Holdings Corp., ("Maple"), Dr Pepper Snapple Group, Inc. ("DPS") and Salt Merger Sub, Inc., ("SMS"), SMS merged on July 9, 2018 into Maple (the "Merger"), with Maple surviving the Merger as a wholly-owned subsidiary of DPS. DPS was renamed Keurig Dr Pepper Inc.("KDP"). The Reporting Person elected to have each issued and outstanding DPS stock option converted into KDP stock options at the effective time of the Merger.
( 2 )The original Form 4 filed on July 10, 2018 (the "Original Form 4") by the Reporting Person erroneously reported a total of 12,074 shares of outstanding DPS stock options converted into 12,074 shares of DPS common stock. The Reporting Person instead opted to have each issued and outstanding DPS stock option converted into KDP stock options pursuant to the Agreement at the effective time of the Merger. As a result the amount of securities beneficially owned by the Reporting Person on the Original Form 4 following the reported transactions should have been reported as 12,461 and not 24,540.
( 3 )The Original Form 4 reported 6,044 shares of outstanding DPS stock options granted on March 2, 2016 converted into 6,044 shares of DPS common stock. The Reporting Person instead had opted to have each issued and outstanding DPS stock option converted into KDP stock options, pursuant to the Merger. Table II should have shown $14.81 in Column 2 and not $94.62; and 37,538 in Column 5(A) and Column 7 and not 6,044; and 37,538 in Column 9 and not 0.
( 4 )The Original Form 4 reported 6,030 shares of outstanding DPS stock options granted on March 2, 2017 converted into 6,030 shares of DPS common stock. The Reporting Person instead had opted to have each issued and outstanding DPS stock option converted into KDP stock options, pursuant to the Merger. Table II should have shown $15.23 in Column 2 and not $91.98; and 37,452 in Column 5(A) and Column 7 and not 6,030; and 37,452 in Column 9 and not 0.

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