Sec Form 4 Filing - CIRCLE K STORES INC @ CrossAmerica Partners LP - 2017-11-10

Insider filing report for Changes in Beneficial Ownership
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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
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
CIRCLE K STORES INC
2. Issuer Name and Ticker or Trading Symbol
CrossAmerica Partners LP [ CAPL]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director X __ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
(Last) (First) (Middle)
1130 WEST WARNER ROAD, BUILDING B
3. Date of Earliest Transaction (MM/DD/YY)
11/10/2017
(Street)
TEMPE, AZ85284
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
_____ Form filed by One Reporting Person
__ X __ 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 Units 11/10/2017 J( 1 )( 2 ) 126,491 ( 2 ) ( 3 ) A $ 26.0889 ( 4 ) 7,070,010 I See Footnote ( 5 )
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
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
CIRCLE K STORES INC
1130 WEST WARNER ROAD
BUILDING B
TEMPE, AZ85284
X
CST BRANDS, LLC
19500 BULVERDE ROAD
SAN ANTONIO, TX78259
X
CST Services LLC
ONE VALERO WAY
19500 BULVERDE ROAD
SAN ANTONIO, TX78259
X
CST USA INC.
19500 BULVERDE ROAD
SAN ANTONIO, TX78259
X
Signatures
/s/ Giovanna Rueda, Authorized Representative of Circle K Stores Inc. 03/05/2018
Signature of Reporting Person Date
/s/ Giovanna Rueda, Corporate Secretary CST Brands, LLC 03/05/2018
Signature of Reporting Person Date
/s/ Giovanna Rueda, Corporate Secretary of CST USA Inc. 03/05/2018
Signature of Reporting Person Date
/s/ Giovanna Rueda, Corporate Secrertary of CST Services LLC 03/05/2018
Signature of Reporting Person Date
Explanation of Responses:
( 1 )Circle K Stores Inc. indirectly owns 100% of CST Brands, LLC, the owner of CST USA Inc., which is the parent of CST Services LLC. As a result, Circle K Stores Inc. is deemed the beneficial owner of theCAPL common units owned by CST Services LLC.
( 2 )Pursuant to that certain Amended and Restated Omnibus Agreement (the "Omnibus Agreement") by and among CrossAmerica Partners LP, a Delaware limited partnership (the "Partnership"), CrossAmericaGP LLC, a Delaware limited liability company and general partner of the Partnership (the "General Partner"), Lehigh Gas Corporation, a Delaware corporation, CST Services LLC, a Delaware limited liabilitycompany ("CST Services"), and Joseph V. Topper, J r., the Partnership is required to pay to CST Services a management fee for providing services to the Partnership (the "Management Fee").
( 3 )The board of directors of the General Partner, based on the approval and recommendation of the independent conflicts committee of the General Partner, determined it is in the best interests of the Partnershipto pay the Management Fee to CST Services in whole or in part in newly issued common units representing limited partner interests in the Partnership ("Common Units") in lieu of cash.
( 4 )Pursuant to the Omnibus Agreement, the price of the acquired Common units was determined using a 20-day trailing volume weighted average price ending on the business day prior to the quarterly invoicedate of October 30, 2017.
( 5 )CST and CST USA are indirect beneficial owners of the Common Units held by CST Services.

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