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OMB APPROVAL
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OMB Number 3235-0104
Expires: September 30, 1998
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Boll, C. Hunter
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(Last) (First) (Middle)
c/o Thomas H. Lee Company
75 State Street
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(Street)
Boston, Massachusetts 02109
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
February 17, 2000
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
COTT CORPORATION (COTT)
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5 Relationship of Reporting Person to Issuer
(Check all applicable)
[ x ] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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6. If Amendment, Date of Original (Month/Year)
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<PAGE>
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7. 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 Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr.5)
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<S> <C> <C> <C>
Common Stock 8,030,119 (5) I (1)
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Common Stock 278,144 (5) I (2)
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Common Stock 781,728 (5) I (3)
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Common Stock 217,438 (5) I (4)
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</TABLE>
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)
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FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 7. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Security Exer- tion of Derivative (I) Ownership
(Instr. 4) cisable Date Title Shares Security (Instr.5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Convertible Participat- Common 3,212,047(5) 10.77(6) I (1)
ing Voting Second Prefer-
red Shares, Series 1
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Convertible Participat- Common 111,258(5) 10.77(6) I (2)
ing Voting Second Prefer-
red Shares, Series 1
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Convertible Participat- Common 312,691(5) 10.77(6) I (3)
ing Voting Second Prefer-
red Shares, Series 1
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Convertible Participat- Common 86,972(5) 10.77(6) I (4)
ing Voting Second Prefer-
red Shares, Series 1
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Option Common 4,015,059(5) 9.00(6) I (1)
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Option Common 139,072(5) 9.00(6) I (2)
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Option Common 390,864(5) 9.00(6) I (3)
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Option Common 108,719(5) 9.00(6) I (4)
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</TABLE>
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Explanation of Responses:
(1) Represents shares/options owned by Thomas H. Lee Equity Fund IV, L.P.
(2) Represents shares/options owned by Thomas H. Lee Foreign Fund IV, L.P.
(3) Represents shares/options owned by Thomas H. Lee Foreign Fund IV-B, L.P.
(4) Represents shares/options owned by THL-Coinvestors III-B, LLC.
(5) The Reporting Person disclaims beneficial ownership of such shares/options
except to the extent of its pecuniary interest in the entity.
(6) Subject to anti-dilution and other adjustments. Each share of Preferred
Stock is currently convertible into 1.398837831 shares of Common Stock.
/s/C. Hunter Boll 2/25/2000
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**Signature of Reporting Person Date
** 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 provided is insufficient. See Instruction 6 for procedure.