SEC Form 5
FORM 5 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol MOLSON COORS BREWING CO [ TAP ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 12/31/2017 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Class B Common Stock | 06/09/2017 | G | 63,060 | D | $0.000 | 0(1) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2013 Grantor Retained Annuity Trust XV | |||||||
Class B Common Stock | 09/15/2017 | G | 35,136 | D | $0.000 | 0(2) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2013 Grantor Retained Annuity Trust XVI | |||||||
Class B Common Stock | 12/11/2017 | G | 21,324 | D | $0.000 | 0(3) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2014 Grantor Retained Annuity Trust XIX | |||||||
Class B Common Stock | 258,119(1)(2)(3)(4) | D | |||||||||||||
Class B Common Stock | 13,536,806 | I | by Adolph Coors Company LLC | ||||||||||||
Class B Common Stock | 0(1) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2013 Grantor Retained Annuity Trust XIV | ||||||||||||
Class B Common Stock | 38,679 | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2014 Grantor Retained Annuity Trust XVII | ||||||||||||
Class B Common Stock | 12,151 | I | by Marilyn & Peter Coors as Co-Trustees of Peter H Coors 2015 Grantor Retained Annuity Trust XX | ||||||||||||
Class B Common Stock | 43,485(2) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2015 Grantor Retained Annuity Trust XXI | ||||||||||||
Class B Common Stock | 63,864(2) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2016 Grantor Retained Annuity Trust XXII | ||||||||||||
Class B Common Stock | 105,097(1) | I | by Marilyn E & Peter H Coors, Co-Trustees of Peter H Coors 2017 Grantor Retained Annuity Trust XXIV | ||||||||||||
Class B Common Stock | 151,078(4) | I | by PHC Funding LLC | ||||||||||||
Class B Common Stock | 1,064 | I | by Spouse |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 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 (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. On June 9, 2017, the Peter H. Coors 2013 Grantor Annuity Trust XV terminated and in connection therewith, (i) 63,060 shares of Class B common stock were distributed to various descendants' trusts and (ii) 22,021 shares of Class B common stock were transferred to the Peter H. Coors 2017 Grantor Annuity Trust XXIV. In addition, on June 9, 2017, (A) the reporting person transferred 77,281 shares of Class B common stock to the Peter H. Coors 2017 Grantor Annuity Trust XXIV, and (B) 5,795 shares of Class B common stock were transferred from the Peter H. Coors 2013 Grantor Annuity Trust XIV to the Peter H. Coors 2017 Grantor Annuity Trust XXIV. |
2. On September 15, 2017, the Peter H. Coors 2013 Grantor Annuity Trust XVI terminated and in connection therewith, (i) 35,136 shares of Class B common stock were distributed to various descendants' trusts and (ii) 12,980 shares of Class B common stock were transferred directly to the reporting person. In addition, on September 15, 2017, (A) the Peter H. Coors 2015 Grantor Annuity Trust XXI transferred 12,915 shares of Class B common stock directly to the reporting person, and (B) the Peter H. Coors 2016 Grantor Annuity Trust XXII transferred 90,000 shares of Class B common stock directly to the reporting person. |
3. On December 11, 2017, the Peter H. Coors 2014 Grantor Annuity Trust XIX terminated and in connection therewith, (i) 21,324 shares of Class B common stock were distributed to various descendants' trusts and (ii) 35,183 shares of Class B common stock were transferred directly to the reporting person. |
4. Reflects the transfer of 151,078 shares of Class B common stock by the reporting person to PHC Funding LLC. |
Remarks: |
Kathleen M. Kirchner, Power of Attorney | 02/14/2018 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |