SEC Form 4 · accession 0001543134-16-000059
ANDEAVOR · ANDV
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Rodney F Chase
Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 5, 2016 · 11:37 am EST
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,F4,F1,F3 | — | Dec 31, 2015 | A | 5 | A | — | — | Common Stock | 5 | 934 | 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 compensation program for 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.
- F4Balance includes multiple phantom stock grants and previously accrued dividend equivalents.