SEC Form 4 · accession 0001351541-17-000283

Delek US Holdings, Inc. · DK

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — EVP / COO

Period of report

Jul 1, 2017

Accepted (ET)

Jul 3, 2017 · 9:50 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 Stock^F1	Jul 1, 2017	D	210,170	—	D	0	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	D/I
Stock Appreciation Right^F2	$6.98	Jul 1, 2017	D	3,250	D	—	Jun 10, 2020	Common Stock	3,250	D
Stock Appreciation Right^F2	$14.25	Jul 1, 2017	D	4,875	D	—	Jun 10, 2021	Common Stock	4,875	D
Employee Stock Option (Right to Buy)^F3	$9.17	Jul 1, 2017	D	15,000	D	—	Jun 10, 2019	Common Stock	15,000	D
Employee Stock Option (Right to Buy)^F3,F4	$9.17	Jul 1, 2017	D	2,177	D	—	May 9, 2016	Common Stock	2,177	D

F1Pursuant to the Agreement and Plan of Merger, dated as of January 2, 2017, as amended, by and among Delek US Holdings, Inc. ("Old Delek"), Alon USA Energy, Inc., and certain other parties thereto (the "Merger Agreement"), each outstanding share of common stock of Old Delek was exchanged on a one-for-one basis for a share of common stock of Delek Holdco, Inc., which was renamed Delek US Holdings, Inc. ("New Delek") in connection with the mergers provided for in the Merger Agreement.
F2Pursuant to the Merger Agreement, each Stock Appreciation Right ("SAR"), whether vested or unvested, was automatically converted into an equivalent New Delek SAR.
F3Pursuant to the Merger Agreement, each stock option, whether vested or unvested, was automatically converted into an equivalent New Delek stock option.
F4The correct expiration date for the stock option is June 10, 2018.