Statement of Changes in Beneficial Ownership (4)
26 5월 2017 - 5:51AM
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).
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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
*
SHAICH RONALD M
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2. Issuer Name
and
Ticker or Trading Symbol
PANERA BREAD CO
[
PNRA
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chairman and CEO
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(Last)
(First)
(Middle)
THREE CHARLES RIVER PLACE,, 63 KENDRICK STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/23/2017
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(Street)
NEEDHAM, MA 02494
(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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Class B Common Stock
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1/13/2017
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G
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V
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8196
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D
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$0.00
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797501
(1)
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I
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By Trusts
(2)
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Class B Common Stock
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5/23/2017
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C
(3)
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191000
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D
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$0.00
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167899
(4)
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D
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Class A Common Stock
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5/23/2017
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C
(3)
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191000
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A
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$0.00
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266524
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D
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Class A Common Stock
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5/24/2017
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G
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V
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191000
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D
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$0.00
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75524
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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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Explanation of Responses:
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(1)
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Upon termination of the Ronald M. Shaich 2011 Qualified Annuity Trust, a grantor retained annuity trust of which the Reporting Person was a trustee, 8,196 shares were transferred on January 13, 2017 to the Shaich Education Trust, a trust of which the Reporting Person is not a trustee. Also reflects the January 13, 2017 transfer of 6,911 shares from the Ronald M. Shaich 2011 Qualified Annuity Trust to the Reporting Person and the November 11, 2016 transfer of 299,814 shares from the Reporting Person to the Ronald M. Shaich 2016 Qualified Annuity Trust #2, a grantor retained annuity trust of which the Reporting Person is a trustee. The transfers described in the immediately preceding sentence are exempt pursuant to Rule 16a-13 under the Securities Exchange Act of 1934; and each transfer represents a change in the form of beneficial ownership with no change in pecuniary interest.
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(2)
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Consists of 299,814 shares held by Ronald M. Shaich 2016 Qualified Annuity Trust #2, 181,443 shares held by Ronald M. Shaich 2016 Qualified Annuity Trust, 269,154 shares held by Ronald M. Shaich 2015 Qualified Annuity Trust and 47,090 shares held by SGC Trust LLC, owned by Shaich Grandchildren's Trust of which Mr. Shaich is an investment trustee.
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(3)
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Represents the conversion of Class B Common Stock into Class A Common Stock.
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(4)
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Reflects the January 13, 2017 transfer of 6,911 shares from the Ronald M. Shaich 2011 Qualified Annuity Trust to the Reporting Person and the November 11, 2016 transfer of 299,814 shares from the Reporting Person to the Ronald M. Shaich 2016 Qualified Annuity Trust #2, a trust of which the Reporting Person is a trustee. These transfers are exempt pursuant to Rule 16a-13 under the Securities Exchange Act of 1934; and each transfer represents a change in the form of beneficial ownership with no change in pecuniary interest.
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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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SHAICH RONALD M
THREE CHARLES RIVER PLACE,
63 KENDRICK STREET
NEEDHAM, MA 02494
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X
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X
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Chairman and CEO
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Signatures
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/s/ Louis DiPietro, Attorney in Fact for Ronald M. Shaich
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5/25/2017
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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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