SEC Form 4 · accession 0001694426-17-000093

Delek US Holdings, Inc. · DK

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

Reporting owner

Director

Period of report

Jul 1, 2017

Accepted (ET)

Jul 5, 2017 · 6:19 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001694426

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	A	25,535	—	A	25,535	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Stock Option (Right to Buy)^F1	$9.17	Jul 1, 2017	A	2,010	A	Jun 10, 2012	Jun 10, 2018	Common Stock	2,010	2,010	D
Stock Option (Right to Buy)^F1	$9.17	Jul 1, 2017	A	3,000	A	Jun 10, 2013	Jun 10, 2019	Common Stock	3,000	3,000	D
Stock Appreciation Right^F1	$6.98	Jul 1, 2017	A	1,500	A	—	Jun 10, 2020	Common Stock	1,500	1,500	D

F1Effective July 1, 2017, Delek US Holdings, Inc. ("New Delek", formerly Delek Holdco, Inc.), Delek US Energy, Inc. ("Old Delek", formerly Delek US Holdings, Inc.), certain subsidiaries of New Delek, and Alon USA Energy, Inc. ("Alon") consummated mergers (the "Mergers") as a result of which Old Delek become a direct wholly owned subsidiary, and Alon became a direct and indirect wholly owned subsidiary, of New Delek. Pursuant to the Mergers, among other things, (i) each share of common stock of Old Delek was converted into one share of common stock of New Delek and (ii) each outstanding equity award granted under Old Delek's long-term incentive plans, whether vested or unvested, were automatically assumed by New Delek and converted into an equity award denominated in shares of New Delek common stock with substantially the same terms and conditions.