SEC Form 4 · accession 0000050104-17-000081
ANDEAVOR · ANDV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert W Goldman
Director
Period of report
Mar 31, 2017
Accepted (ET)
Apr 4, 2017 · 7:10 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000050104
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Phantom StockF2,F1,F3 | — | Mar 31, 2017 | A | 11 | A | — | — | Common Stock | 11 | 1,728 | D |
Explanation of responses
- F1Security deemed to convert to common stock on a one for one basis.
- F2Dividend equivalent rights accrued to previously granted phantom stock awards, which were part of the compensation program of non-employee directors.
- F3Vesting and payout occurs on the earliest of death, disability or the vesting and payout of the underlying award with respect to which the dividend equivalents relate.