SEC Form 4 · accession 0001351541-17-000182
Delek US Holdings, Inc. · DK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald Norman Holmes
Officer — Executive Vice President
Period of report
Jun 5, 2017
Accepted (ET)
Jun 7, 2017 · 5:08 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001351541
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Jun 5, 2017 | M | 1,625 | $10.65 | A | 31,688 | D | |
| Common StockF2 | Jun 5, 2017 | D | 677 | $25.60 | D | 31,011 | D | |
| Common StockF3 | Jun 5, 2017 | F | 260 | $25.60 | D | 30,751 | D | |
| Common StockF1 | Jun 5, 2017 | S | 688 | $25.5604 | D | 30,063 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Appreciation RightF4 | $10.65 | Jun 5, 2017 | M | 1,625 | D | — | Dec 10, 2021 | Common Stock | 1,625 | 2,500 | D |
Explanation of responses
- F1The reported 688 shares of Common Stock sold on June 5, 2017 were acquired upon exercise of a stock appreciation right on the same date.
- F2Disposition 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.
- F3Shares withheld to cover tax withholding obligations in connection with the exercise of the stock appreciation right.
- F4The stock appreciation right vested with respect to 8,125 shares on each of December 10, 2012, December 10, 2013 and December 10, 2014 and December 10, 2015.