| 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
|
| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Expires: |
December 31, 2014 |
| Estimated average burden |
| hours per response: |
0.5 |
|
|
1. Name and Address of Reporting Person
*
| C/O KRISPY KREME, INC. |
| 2116 HAWKINS STREET |
(Street)
|
2. Date of Event Requiring Statement
(Month/Day/Year)
06/30/2022
|
3. Issuer Name
and
Ticker or Trading Symbol
Krispy Kreme, Inc.
[
DNUT
]
|
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
| X |
Director |
|
10% Owner |
|
Officer (give title below) |
|
Other (specify below) |
|
|
5. 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 Beneficially Owned |
|---|
| 1. Title of Security (Instr.
4)
|
2.
Amount of Securities Beneficially Owned (Instr.
4)
|
3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
4. Nature of Indirect Beneficial Ownership (Instr.
5)
|
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
|---|
| 1. Title of Derivative Security (Instr.
4)
|
2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
|
4. Conversion or Exercise Price of Derivative Security
|
5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
|
6. Nature of Indirect Beneficial Ownership (Instr.
5)
|
| Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
| Explanation of Responses: |
|
/s/ Lisa Brown, Attorney-in-Fact |
07/06/2022 |
|
** 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. |
LIMITED POWER OF ATTORNEY
FOR
SECTION 16 REPORTING OBLIGATIONS
Know all by these presents, that the undersigned hereby makes, constitutes and appoints each of
Lisa Brown, Catherine Tang, Rebecca Morley, Maria Love, and Dean Brazier, Jr., each acting
individually, as the undersigned's true and lawful attorney-in-fact, with full power and authority
as hereinafter described on behalf of and in the name, place and stead of the undersigned to:
1. prepare, execute in the undersigned's name and on the undersigned's behalf, and submit
to the U.S. Securities and Exchange Commission (the "SEC") a Form ID, including
amendments thereto, and any other documents necessary or appropriate to obtain codes
and passwords enabling the undersigned to make electronic filings with the SEC of
reports required by Section 16(a) of the Securities Exchange Act of 1934, as amended, or
any rule or regulation of the SEC (the "Exchange Act");
2. prepare, execute for and on behalf of the undersigned, acknowledge, deliver and file
Forms 3, 4 and 5 (including any amendments thereto) with respect to the securities of
Krispy Kreme, Inc. (the "Company"), with the SEC, any national securities exchanges or
similar authority and the Company, as considered necessary or advisable under Section
16(a) of the Exchange Act and to do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and execute any
amendment or amendments thereto, and timely file such form with the SEC, any national
securities exchanges or similar authority;
3. seek or obtain, as the undersigned's representative and on the undersigned's behalf,
information on transactions in the Company's securities from any third party, including
brokers, employee benefit plan administrators and trustees, and the undersigned hereby
authorizes any such person to release any such information to the undersigned and
approves and ratifies any such release of information; and
4. perform any and all other acts in connection with the foregoing which, in the opinion of
such attorney-in-fact, may be of benefit to, in the best interest of or legally required by,
the undersigned, it being understood that the documents executed by such attorney-in-fact
on behalf of the undersigned pursuant to this Limited Power of Attorney shall be in such
form and shall contain such terms and conditions as such attorney-in-fact may approve in
such attorney-in-fact's discretion.
The undersigned acknowledges that:
1. this Limited Power of Attorney authorizes, but does not require, each such attorney-in-
fact to act in their discretion on information provided to such attorney-in-fact without
independent verification of such information;
2. any documents prepared and/or executed by either such attorney-in-fact on behalf of the
undersigned pursuant to this Limited Power of Attorney will be in such form and will
contain such information and disclosure as such attorney-in-fact, in his or her discretion,
deems necessary or desirable;
3. neither the Company nor either of such attorneys-in-fact assumes (i) any liability for the
undersigned's responsibility to comply with the requirement of the Exchange Act, (ii)
any liability of the undersigned for any failure to comply with such requirements, or (iii)
any obligation or liability of the undersigned for profit disgorgement under Section 16(b)
of the Exchange Act; and
4. this Limited Power of Attorney does not relieve the undersigned from the responsibility
for compliance with the undersigned's obligations under the Exchange Act, including,
without limitation, the undersigned's obligations under Section 16 of the Exchange Act.
The undersigned hereby gives and grants each of the foregoing attorneys-in-fact full power and
authority to do and perform all and every act and thing whatsoever requisite, necessary or
appropriate to be done in and about the foregoing matters as fully ratifying all that each such
attorney-in-fact of, for and on behalf of the undersigned, shall lawfully do or cause to be done by
virtue of this Limited Power of Attorney and the rights and powers herein granted.
This Limited Power of Attorney shall remain in full force and effect until the undersigned is no
longer required to file Forms 3, 4 and 5 with respect to the undersigned's holdings of and
transactions in securities issued by the Company, unless earlier revoked by the undersigned in a
signed writing delivered to the foregoing attorneys-in-fact.
IN WITNESS WHEREOF, the undersigned has caused this Limited Power of Attorney to be
executed as of July 5 , 2022.
/s/ Gerhard Pleuhs
Gerhard Pleuhs
1
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