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