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| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 DECLARATION OF CHANGES IN ECONOMIC OWNERSHIP Filed under Section 16 (a) of the Securities Exchange Act of 1934 |
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Check this box if you are no longer subject to Section 16. The obligations according to Form 4 or Form 5 can continue to exist. Statement 1 (b). |
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1. Name and address of the reporting person
(Street) |
2. Name of the issuer CrossAmerica Partners LP [ CAPL ] |
5. Relationship of the reporting person (s) to the issuer (Check all that apply)
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3. Earliest transaction date (month / day / year) 02/25/2021 |
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| 4. If changed, date of original submission (month / day / year) |
6. Individual or joint / group registration (check the relevant line)
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| Table I – Non-Derivative Securities Purchased, Sold, or Economically Owned | ||||||||||
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| 1. Title of the security (Instr. 3) | 2. Transaction date (month / day / year) | 2A. Considered execution date, if available (month / day / year) | 3. Transaction code (Instr. 8) | 4. Acquired (A) or sold (D) securities (instr. 3, 4 and 5) | 5. Amount of the securities in beneficial ownership after the reported transaction (s) (instr. 3 and 4) | 6. Form of ownership: Direct (D) or Indirect (I) (Instr. 4) | 7. Type of indirect beneficial ownership (Instr. 4) | |||
| code | V | Be | (A) or (D) | price | ||||||
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Table II – Derivative Securities Purchased, Sold, or Economically Owned (e.g. puts, calls, warrants, options, convertible securities) |
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| 1. Title of the derivative security (instr. 3) | 2. Conversion or exercise price of derivative securities | 3. Transaction date (month / day / year) | 3A. Considered execution date, if available (month / day / year) | 4. Transaction code (Instr. 8) | 5. Number of acquired (A) or sold derivative securities (D) (instr. 3, 4 and 5) | 6. Exercise date and expiry date (month / day / year) | 7. Title and amount of the securities on which a derivative (instr. 3 and 4) is based | 8. Price of the derivative security (instr. 5) | 9. Number of derivative securities in beneficial ownership after reported transaction (s) (instr. 4) | 10. Form of ownership: Direct (D) or Indirect (I) (Instr. 4) | 11. Type of indirect beneficial ownership (Instr. 4) | ||||
| code | V | (A) | (D) | Date exercisable | Best before date | title | Amount or number of shares | ||||||||
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Phantom units
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02/25/2021 | A |
1,509
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Common units |
1,509.00 |
$ 0
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1,509 |
D. |
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| Explanation of the answers: |
| / s / Christina Casey-Best Lawyer for John B. Reilly, III | 03/01/2021 | |
| ** Signature of the reporter | date | |
| As a reminder, report on a separate line for each class of securities that are directly or indirectly beneficial. | ||
| * If the form is submitted by more than one whistleblower, see Statement 4 (b) (v). |
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| ** Deliberate false statements or omissions of facts constitute criminal offenses by the federal government See 18 USC 1001 and 15 USC 78ff (a). |
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| Note: Submit three copies of this form, one of which must be manually signed. If there is not enough space, see Procedure 6. |
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| Individuals responding to the information collection on this form are not required to respond unless the form includes a currently valid OMB number. | ||
POWER OF ATTORNEY
KNOW ALL BY THESE PRESENTS, that the undersigned hereby appoints Christina Casey-Best and Keenan D. Lynch, as the undersigned's true and lawful attorneys-in-fact to act for and on behalf of and in the name, place and stead of the undersigned to:
1. prepare, execute and file, for and on behalf of the undersigned any and all documents and filings that are required or advisable to be made with the United States Securities and Exchange Commission, any stock exchange or similar authority, under Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), and the rules and regulations promulgated thereunder, including without limitation any Form 3, 4, or 5 (or any successor schedules or forms adopted under the Exchange Act) and any amendments to any of the foregoing; and
2. take any other action of any type whatsoever 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 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 hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, herby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted.
All prior Powers of Attorney are hereby revoked. This Power of Attorney shall remain in full force and effect until revoked by the undersigned in a signed writing delivered to an attorney-in-fact.
This Power of Attorney shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania, without giving effect to any principles of conflicts of laws.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 22nd day of October 2020.
/s/
John B. Reilly
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