SEC Form 4 · accession 0001351541-17-000226
Delek US Holdings, Inc. · DK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Donald Norman Holmes
Officer — Executive Vice President
Period of report
Jun 14, 2017
Accepted (ET)
Jun 16, 2017 · 10:11 am 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 14, 2017 | M | 2,375 | $16.21 | A | 31,864 | D | |
| Common StockF2 | Jun 14, 2017 | D | 1,393 | $27.64 | D | 30,471 | D | |
| Common StockF3 | Jun 14, 2017 | F | 269 | $27.64 | D | 30,202 | D | |
| Common StockF1 | Jun 14, 2017 | S | 713 | $27.70 | D | 29,489 | 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 | $16.21 | Jun 14, 2017 | M | 2,375 | D | — | Jun 10, 2022 | Common Stock | 2,375 | 4,125 | D |
Explanation of responses
- F1The reported 713 shares of common stock sold on June 14, 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 6,500 shares on each of June 10, 2013, June 10, 2014, June 10, 2015 and June 10, 2016.