0000050104-17-000221.txt : 20171012 0000050104-17-000221.hdr.sgml : 20171012 20171012191004 ACCESSION NUMBER: 0000050104-17-000221 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171010 FILED AS OF DATE: 20171012 DATE AS OF CHANGE: 20171012 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: WARNER CYNTHIA J CENTRAL INDEX KEY: 0001570212 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-03473 FILM NUMBER: 171135322 MAIL ADDRESS: STREET 1: 1925 WEST FIELD COURT STREET 2: SUITE 200 CITY: LAKE FOREST STATE: IL ZIP: 60045 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ANDEAVOR CENTRAL INDEX KEY: 0000050104 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 950862768 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 19100 RIDGEWOOD PKWY CITY: SAN ANTONIO STATE: TX ZIP: 78259-1828 BUSINESS PHONE: 210 626-6000 MAIL ADDRESS: STREET 1: 19100 RIDGEWOOD PKWY CITY: SAN ANTONIO STATE: TX ZIP: 78259-1828 FORMER COMPANY: FORMER CONFORMED NAME: TESORO CORP /NEW/ DATE OF NAME CHANGE: 20041108 FORMER COMPANY: FORMER CONFORMED NAME: TESORO PETROLEUM CORP /NEW/ DATE OF NAME CHANGE: 19920703 4 1 wf-form4_150784979107075.xml FORM 4 X0306 4 2017-10-10 0 0000050104 ANDEAVOR ANDV 0001570212 WARNER CYNTHIA J 19100 RIDGEWOOD PARKWAY SAN ANTONIO TX 78259 0 1 0 0 EVP, Operations Common Stock 2017-10-10 4 M 0 17715 A 33945 D Common Stock 2017-10-10 4 F 0 7432 106.33 D 26513 D Market Stock Units 2017-10-10 4 M 0 10169 0 D Common Stock 10169.0 0 D Represents the vesting and settlement of a market stock unit award previously granted under the Amended and Restated Andeavor 2011 Long-Term Incentive Plan. The market stock units vested on the third anniversary of the grant date, were adjusted based upon stock price performance multiple of the Issuer, and were settled in shares of common stock upon certification of such stock price performance multiple by the Compensation Committee of the Issuer. These shares of common stock were automatically withheld by the Issuer to satisfy tax withholding obligations associated with the vesting of the market stock unit award described in footnote 1. /s/ Elisa D. Watts, Attorney-in-Fact for Cynthia J. Warner 2017-10-12