SEC Form 4 · accession 0001245156-16-000078
ANDEAVOR · ANDV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Tracy Dawn Jackson
Officer — VP and Controller
Period of report
Feb 10, 2016
Accepted (ET)
Feb 12, 2016 · 1:15 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000050104
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 10, 2016 | M | 2,800 | — | A | 11,069 | D | |
| Common StockF3 | Feb 10, 2016 | F | 765 | $74.01 | D | 10,304 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Market Stock Unit AwardF6,F4,F5,F1 | — | Feb 10, 2016 | M | 1,400 | D | — | — | Common Stock | 2,800 | 4,533 | D |
Explanation of responses
- F1Payment of common shares that vested and settled pursuant to Market Stock Unit Award originally granted by the Compensation Committee of the Board of Directors on February 4, 2013 pursuant to the Company's 2011 Long-Term Incentive Plan. The potential payout for the MSU Award at vesting ranged from 50% to 200% with payout certified by the Compensation Committee at 200%.
- F2The Company's Long-Term Incentive Plan permits grantees to pay the federal income tax liability with shares thereby reducing the awards listed above.
- F3Balance includes l,611 shares in the Company's Thrift Plan.
- F4Each market stock unit award represents a contingent right to receive one share of TSO common stock at target payout levels.
- F5The market stock unit award vested on February 4, 2016, but settled in stock upon certification by the Compensation Committee on February 10, 2016.
- F6Award granted by the Compensation Committee of the Board of Directors.