SEC Form 4 · accession 0001694426-17-000200
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 (DK)
Period of report
Nov 20, 2017
Accepted (ET)
Nov 22, 2017 · 5:16 pm EST
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 | Nov 20, 2017 | M | 1,000 | $10.65 | A | 30,489 | D | |
| Common StockF2 | Nov 20, 2017 | D | 355 | $30.00 | D | 30,134 | D | |
| Common StockF3 | Nov 20, 2017 | F | 177 | $30.00 | D | 29,957 | D | |
| Common StockF1 | Nov 20, 2017 | S | 468 | $30.00 | D | 29,489 | D | |
| Common StockF4 | Nov 20, 2017 | M | 1,000 | $16.21 | A | 30,489 | D | |
| Common StockF2 | Nov 20, 2017 | D | 541 | $30.00 | D | 29,948 | D | |
| Common StockF3 | Nov 20, 2017 | F | 126 | $30.00 | D | 29,822 | D | |
| Common StockF4 | Nov 20, 2017 | S | 333 | $30.00 | 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 RightF5 | $10.65 | Nov 20, 2017 | M | 1,000 | D | — | Dec 10, 2021 | Common Stock | 1,000 | 0 | D |
| Stock Appreciation RightF6 | $16.21 | Nov 20, 2017 | M | 1,000 | D | — | Jun 10, 2022 | Common Stock | 1,000 | 0 | D |
Explanation of responses
- F1The reported 468 shares of common stock sold on November 20, 2017 were acquired upon exercise of a stock appreciation right on the same day.
- 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 the tax withholding obligation in connection with the exercise of the stock appreciation right.
- F4The reported 333 shares of common stock sold on November 20, 2017 were acquired upon exercise of a stock appreciation right on the same date.
- F5The stock appreciation right vested with respect to 8,125 shares on each of December 10, 2012, 2013, 2014 and 2015.
- F6The stock appreciation right vested with respect to 6,500 shares on each of June 10, 2013, 2014, 2015 and 2016.