0001209191-16-093163.txt : 20160122 0001209191-16-093163.hdr.sgml : 20160122 20160122170359 ACCESSION NUMBER: 0001209191-16-093163 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20160120 FILED AS OF DATE: 20160122 DATE AS OF CHANGE: 20160122 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Northern Tier Energy LP CENTRAL INDEX KEY: 0001533454 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 800763623 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1250 W. WASHINGTON STREET STREET 2: SUITE 300 CITY: TEMPE STATE: AZ ZIP: 85281 BUSINESS PHONE: (602) 302-5450 MAIL ADDRESS: STREET 1: 1250 W. WASHINGTON STREET STREET 2: SUITE 300 CITY: TEMPE STATE: AZ ZIP: 85281 FORMER COMPANY: FORMER CONFORMED NAME: Northern Tier Energy, Inc. DATE OF NAME CHANGE: 20111025 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Duckworth Rocky L CENTRAL INDEX KEY: 0001561024 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35612 FILM NUMBER: 161356797 MAIL ADDRESS: STREET 1: TWO CITY PLACE, SUITE 1700 STREET 2: 100 THROCKMORTON CITY: FORT WORTH STATE: TX ZIP: 76102 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2016-01-20 0 0001533454 Northern Tier Energy LP NTI 0001561024 Duckworth Rocky L C/O NORTHERN TIER ENERGY LP 1250 W WASHINGTON ST, SUITE 300 TEMPE AZ 85281 1 0 0 0 Common Unit 2016-01-20 4 M 0 4846 0.00 A 12317 D Phantom Unit 2016-01-20 4 M 0 4846 0.00 D Common Units 4846 0 D Phantom Unit 2016-01-20 4 A 0 4202 0.00 A Common Units 4202 4202 D These common units were issued pursuant to a phantom unit award granted to the reporting person on January 21, 2015 (the "2015 Phantom Unit Award"), settled at the election of the Compensation Committee of the Board of Directors (the "Board") of Northern Tier Energy GP LLC ("NTI GP"), the general partner of NTI, in NTI common units. Each phantom unit represents a contingent right to receive one common unit representing a limited partner interest in NTI or, at the election of the Board, or such Committee as may be appointed by the Board, the cash value thereof. The phantom units were awarded as compensation for services as a director of NTI GP. The 2015 Phantom Unit Award vested on January 20, 2016, and, at the election of the Compensation Committee of the Board, was settled in NTI common units. These phantom units are scheduled to vest on January 18, 2017. The vested common units underlying the phantom units, or the cash value thereof, will be delivered to the reporting person on or promptly following the vesting date applicable thereto, but no later than the 70th calendar day following the vesting of the phantom units. /s/ Rocky L. Duckworth 2016-01-22