0001351541-17-000296.txt : 20170703 0001351541-17-000296.hdr.sgml : 20170703 20170703095624 ACCESSION NUMBER: 0001351541-17-000296 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170701 FILED AS OF DATE: 20170703 DATE AS OF CHANGE: 20170703 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Delek US Holdings, Inc. CENTRAL INDEX KEY: 0001351541 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 522319066 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 615-771-6701 MAIL ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Page Mark T. CENTRAL INDEX KEY: 0001701861 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32868 FILM NUMBER: 17944393 MAIL ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 4 1 wf-form4_149909008240603.xml FORM 4 X0306 4 2017-07-01 1 0001351541 Delek US Holdings, Inc. DK 0001701861 Page Mark T. 7102 COMMERCE WAY BRENTWOOD TN 37027 0 1 0 0 Executive Vice President Common Stock 2017-07-01 4 D 0 21061 D 0 D Stock Appreciation Right 16.21 2017-07-01 4 D 0 800 D 2022-06-10 Common Stock 800.0 0 D Stock Appreciation Right 26.41 2017-07-01 4 D 0 24500 D 2022-12-10 Common Stock 24500.0 0 D Stock Appreciation Right 34.75 2017-07-01 4 D 0 6500 D 2023-06-10 Common Stock 6500.0 0 D Pursuant to the Agreement and Plan of Merger, dated as of January 2, 2017, as amended, by and among Delek US Holdings, Inc. ("Old Delek"), Alon USA Energy, Inc., and certain other parties thereto (the "Merger Agreement"), each outstanding share of common stock of Old Delek was exchanged on a one-for-one basis for a share of common stock of Delek Holdco, Inc., which was renamed Delek US Holdings, Inc. ("New Delek") in connection with the mergers provided for in the Merger Agreement. Pursuant to the Merger Agreement, each Stock Appreciation Right ("SAR"), whether vested or unvested, was automatically converted into an equivalent New Delek SAR. /s/ Mark T. Page 2017-07-03