Filing Details
- Accession Number:
- 0001351541-17-000080
- Form Type:
- 4/A
- Zero Holdings:
- No
- Publication Time:
- 2017-03-20 19:17:14
- Reporting Period:
- 2017-03-10
- Filing Date:
- 2017-03-20
- Accepted Time:
- 2017-03-20 19:17:14
- Original Submission Date:
- 2017-03-14
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1351541 | Delek Us Holdings Inc. | DK | Petroleum Refining (2911) | 522319066 |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1650395 | L. Anthony Miller | 7102 Commerce Way Brentwood TN 37027 | Executive Vice President | No | Yes | No | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | Acquisiton | 2017-03-10 | 1,625 | $16.21 | 14,527 | No | 4 | M | Direct | |
| Common Stock | Disposition | 2017-03-10 | 1,112 | $23.70 | 13,415 | No | 4 | D | Direct | |
| Common Stock | Disposition | 2017-03-10 | 168 | $23.70 | 13,247 | No | 4 | F | Direct | |
| Common Stock | Disposition | 2017-03-10 | 345 | $23.70 | 12,902 | No | 4 | S | Direct | |
| Common Stock | Disposition | 2017-03-10 | 3,681 | $23.68 | 9,221 | No | 4 | S | Direct | |
| Common Stock | Disposition | 2017-03-10 | 358 | $23.90 | 8,863 | No | 4 | F | Direct | |
| Common Stock | Acquisiton | 2017-03-10 | 5,856 | $0.00 | 14,719 | No | 4 | A | Direct |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | M | Direct | |
| No | 4 | D | Direct | |
| No | 4 | F | Direct | |
| No | 4 | S | Direct | |
| No | 4 | S | Direct | |
| No | 4 | F | Direct | |
| No | 4 | A | Direct |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Stock Appreciation Right | Disposition | 2017-03-10 | 1,625 | $16.21 | 1,625 | $16.21 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 0 | 2022-06-10 | No | 4 | M | Direct |
Footnotes
- This amendment is being filed to amend the Form 4 filed by the reporting person on March 14, 2017 (the "Original Form") to clarify that a portion of the reported 4,026 shares of Common Stock sold on March 10, 2017 were acquired upon exercise of a stock appreciation right on the same date and to correct the number of shares beneficially owned following such exercise in column 5 of Table I.
- This amendment is being filed to also report the disposition of shares of Common Stock to Delek US Holdings, Inc. for payment of the exercise price in connection with the exercise of the stock appreciation right that was not previously reported in the Original Form 4.
- This amendment is being filed to also report the shares withheld to cover tax withholding obligations in connection with the exercise of the stock appreciation right that was not previously reported in the Original Form 4.
- The price reflects the weighted average sale price of multiple transactions ranging from a low sale price of $23.68 per share to a high sale price of $23.6950 per share. Upon the written request of the SEC, the Issuer or a security holder of the Issuer, the reporting person agrees to provide the number of shares sold at each sale price.
- The stock appreciation right vested with respect to 1,625 shares of Common Stock on each of June 10, 2013, June 10, 2014, June 10, 2015 and June 10, 2016.
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