0001376139-18-000080.txt : 20181218 0001376139-18-000080.hdr.sgml : 20181218 20181218172747 ACCESSION NUMBER: 0001376139-18-000080 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181214 FILED AS OF DATE: 20181218 DATE AS OF CHANGE: 20181218 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jackson Tracy Dawn CENTRAL INDEX KEY: 0001512565 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33492 FILM NUMBER: 181241424 MAIL ADDRESS: STREET 1: 19100 RIDGEWOOD PARKWAY CITY: SAN ANTONIO STATE: TX ZIP: 78259 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CVR ENERGY INC CENTRAL INDEX KEY: 0001376139 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2277 PLAZA DRIVE STREET 2: SUITE 500 CITY: SUGAR LAND STATE: TX ZIP: 77479 BUSINESS PHONE: (281) 207-7711 MAIL ADDRESS: STREET 1: 2277 PLAZA DRIVE STREET 2: SUITE 500 CITY: SUGAR LAND STATE: TX ZIP: 77479 4 1 wf-form4_154517204984277.xml FORM 4 X0306 4 2018-12-14 0 0001376139 CVR ENERGY INC CVI 0001512565 Jackson Tracy Dawn 2277 PLAZA DRIVE, SUITE 500 SUGAR LAND TX 77479 0 1 0 0 EVP and CFO Incentive Units 2018-12-14 4 A 0 13779 0 A Common Stock 13779.0 13779 D The Incentive Units were awarded to the reporting person by CVR Energy, Inc. as compensation for services as an officer on December 14, 2018. These Incentive Units vest ratably in three annual installments beginning in December of each year following the grant date, subject to the terms of the award agreement. Each Incentive Unit reported herein represents the right to receive upon vesting, a cash payment equal to the average closing price of the common stock of CVR Energy, Inc. for the 10 trading days preceding the vesting date. The Incentive Units expire immediately following their vesting. /s/ Tracy D. Jackson 2018-12-18