SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
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(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 10/21/2021
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3. Issuer Name and Ticker or Trading Symbol
Portillo's Inc.
[ PTLO ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X |
Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Class A common stock |
13,133,967
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I |
By Berkshire Fund VIII-A, L.P.
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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 Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
LLC Units of PHD Group Holdings LLC |
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Class A common stock |
31,609,401
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I |
By Berkshire Fund VIII, L.P.
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LLC Units of PHD Group Holdings LLC |
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Class A common stock |
868,687
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D |
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LLC Units of PHD Group Holdings LLC |
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Class A common stock |
2,861,078
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D |
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
|
(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
|
(Street)
|
1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
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(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET, 35TH FLOOR |
|
(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET |
35TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
200 CLARENDON STREET |
35TH FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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By: See Signatures Included in Exhibit 99.1 |
10/21/2021 |
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** 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
5
(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. |
Exhibit 99.1
Joint Filer Information
Name of Joint Filer: Berkshire Partners LLC
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Partners LLC
By: BPSP, L.P., its managing member
By: Berkshire Partners Holdings LLC, its general partner
/s/ Sharlyn C. Heslam
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Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Berkshire Fund VIII-A, L.P.
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Fund VIII-A, L.P.
By Eighth Berkshire Associates LLC,
its general partner
/s/ Sharlyn C. Heslam
--------------------------------
Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Berkshire Fund VIII, L.P.
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Fund VIII, L.P.
By Eighth Berkshire Associates LLC,
its general partner
/s/ Sharlyn C. Heslam
--------------------------------
Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Berkshire Investors III LLC
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Investors III LLC
/s/ Sharlyn C. Heslam
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Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Berkshire Investors IV LLC
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Investors IV LLC
/s/ Sharlyn C. Heslam
--------------------------------
Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Eighth Berkshire Associates LLC
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Eighth Berkshire Associates LLC
/s/ Sharlyn C. Heslam
--------------------------------
Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: Berkshire Partners Holdings LLC
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
Berkshire Partners Holdings LLC
/s/ Sharlyn C. Heslam
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Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date
Joint Filer Information
Name of Joint Filer: BPSP, L.P.
Address of Joint Filer: 200 Clarendon Street
35th Floor
Boston, MA 02116-5021
Issuer Name and Ticker or Trading Symbol: Portillo's, Inc. [PTLO]
Date of Event Requiring this Statement
(Month/Day/Year): 10/21/2021
Designated Filer: Berkshire Partners LLC
Signature:
BPSP, L.P.
By: Berkshire Partners Holdings LLC, its general partner
/s/ Sharlyn C. Heslam
--------------------------------
Name: Sharlyn C. Heslam
Title: Managing Director
10/21/2021
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Date