SEC FORM 4 SEC Form 4
FORM 4 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
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).
1. Name and Address of Reporting Person*
Wilson Dennis J.

(Last) (First) (Middle)
21 WATER STREET, SUITE 600

(Street)
VANCOUVER A1 V6B 1A1

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
lululemon athletica inc. [ LULU ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Director by deputization
3. Date of Earliest Transaction (Month/Day/Year)
10/01/2020
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 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 3,852 D
Common Stock 4,825,861 I By LIPO Investments (USA) Inc.
Common Stock 10/01/2020 C(1) 177,000 A (2) 177,000 I By Anamered Investments Inc.
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 (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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Exchangeable Shares of Lulu Canadian Holding, Inc. (2) 10/01/2020 C(1) 177,000 (3) (4) Common Stock 177,000 $0.00 4,854,768 I By Anamered Investments Inc.
Exchangeable Shares of Lulu Canadian Holding, Inc. (2) (3) (4) Common Stock 268,984 268,984 I By Shannon Wilson
Exchangeable Shares of Lulu Canadian Holding, Inc. (2) (3) (4) Common Stock 91,760 91,760 I By Five Boys Investments ULC
Explanation of Responses:
1. Shares obtained on conversion of exchangable share of Lulu Canadian Holding, Inc. for shares of lululemon athletica inc. for no consideration exempt under 16b-6b.
2. 1 - 1 exchange ratio.
3. Immediately exchangable for shares of lululemon common stock on a 1-to-1 ratio.
4. No expiration date.
Remarks:
/s/ Dennis J. Wilson 10/05/2020
** 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.
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