SEC Form 4/A · accession 0001694426-17-000123
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).
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Jared Serff
Officer — Executive Vice President
Period of report
Jul 1, 2017
Accepted (ET)
Jul 14, 2017 · 5:52 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 StockF1 | Jul 1, 2017 | A | 1,896 | $0.00 | A | 15,579 | D | |
| Common StockF1 | Jul 1, 2017 | A | 1,896 | $0.00 | A | 17,475 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1This amendment is being filed to amend the Form 4 filed by the reporting person on July 5, 2017, to include additional shares of common stock of Delek US Energy, Inc., formerly Delek US Holdings, Inc. ("Old Delek"), that were converted into common stock of the issuer ("New Delek") in connection with the Mergers described in footnote 1 of such Form 4. Such additional shares were excluded from the reporting person's total shares of Old Delek common stock converted into shares of New Delek common stock due to the erroneous filing, on June 30, 2017, of a Form 4/A with respect to Old Delek common stock previously held by the reporting person.