0001209191-17-000446.txt : 20170103
0001209191-17-000446.hdr.sgml : 20170103
20170103183038
ACCESSION NUMBER: 0001209191-17-000446
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20161230
FILED AS OF DATE: 20170103
DATE AS OF CHANGE: 20170103
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Western Refining, Inc.
CENTRAL INDEX KEY: 0001339048
STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911]
IRS NUMBER: 203472415
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 6500 TROWBRIDGE DRIVE
CITY: EL PASO
STATE: TX
ZIP: 79905
BUSINESS PHONE: (915) 775-3488
MAIL ADDRESS:
STREET 1: 6500 TROWBRIDGE DRIVE
CITY: EL PASO
STATE: TX
ZIP: 79905
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Davis Karen Berriman
CENTRAL INDEX KEY: 0001358598
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-32721
FILM NUMBER: 17503157
MAIL ADDRESS:
STREET 1: 123 WEST MILLS AVENUE
STREET 2: SUITE 200
CITY: EL PASO
STATE: TX
ZIP: 79901
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2016-12-30
0
0001339048
Western Refining, Inc.
WNR
0001358598
Davis Karen Berriman
C/O WESTERN REFINING, INC.
123 W. MILLS AVENUE, SUITE 600
EL PASO
TX
79901
0
1
0
0
EVP and CFO
Common Stock
2016-12-30
4
M
0
10017
0.00
A
11051
D
Common Stock
2016-12-30
4
F
0
4623
0.00
D
6428
D
Phantom Stock
2016-12-30
4
M
0
10017
0.00
D
Common Stock
10017
14709
D
10,017 shares were issued pursuant to a phantom stock award ("Phantom Stock Award") granted to the reporting person on June 23, 2016, which were settled at the election of the Compensation Committee of WNR's Board of Directors (the "Board") in WNR common stock.
These shares of common stock were issuable upon vesting of the Phantom Stock Award, but were withheld to satisfy the reporting person's tax obligations.
These shares of phantom stock represent a contingent right to receive one share of WNR common stock or, at the election of the Compensation Committee of the Board, the cash value thereof. These shares of phantom stock were issued as compensation for services as an officer of Issuer.
These shares of phantom stock vested on December 30, 2016.
This number of derivative securities include (a) 5,325 phantom stock shares that remain outstanding pursuant to a phantom stock award granted on June 23, 2016, and (b) 9,384 phantom stock shares that remain outstanding pursuant to a phantom stock award granted on June 23, 2016.
/s/ Karen B. Davis
2017-01-03