0000726958-21-000010.txt : 20210113 0000726958-21-000010.hdr.sgml : 20210113 20210113184259 ACCESSION NUMBER: 0000726958-21-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210111 FILED AS OF DATE: 20210113 DATE AS OF CHANGE: 20210113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: REBELEZ DARREN M CENTRAL INDEX KEY: 0001484697 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34700 FILM NUMBER: 21527087 MAIL ADDRESS: STREET 1: 1722 ROUTH STREET STREET 2: SUITE 1000 CITY: DALLAS STATE: TX ZIP: 75201-2502 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CASEYS GENERAL STORES INC CENTRAL INDEX KEY: 0000726958 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-AUTO DEALERS & GASOLINE STATIONS [5500] IRS NUMBER: 420935283 STATE OF INCORPORATION: IA FISCAL YEAR END: 0430 BUSINESS ADDRESS: STREET 1: PO BOX 3001 CITY: ANKENY STATE: IA ZIP: 50021 BUSINESS PHONE: 515-965-6100 MAIL ADDRESS: STREET 1: PO BOX 3001 CITY: ANKENY STATE: IA ZIP: 50021 4 1 wf-form4_161058136383570.xml FORM 4 X0306 4 2021-01-11 0 0000726958 CASEYS GENERAL STORES INC CASY 0001484697 REBELEZ DARREN M ONE SE CONVENIENCE BOULEVARD ANKENY IA 50021 1 1 0 0 President and CEO Common Stock 5559 D Common Stock 105 I Voting and tender rights under 401k plan Restricted stock units 2021-01-11 4 A 0 5000 0 A Common Stock 5000.0 5000 D Restricted stock units Common Stock 4241.0 4241 D Restricted stock units Common Stock 6280.0 6280 D Restricted stock units Common Stock 16666.0 16666 D Allocated to Mr. Rebelez's 401k plan account as of January 11, 2021. Does not include any shares allocated by the plan trustee after that date. Represents the number of restricted stock units earned upon achievement of the performance criteria pursuant to the terms and conditions of Mr. Rebelez's "special strategic grant" of December 23, 2019. The restricted stock units remain subject to service-based vesting, and will vest in equal installments on January 15, 2021, January 15, 2022 and January 15, 2023. Each restricted stock unit represents the right to receive, following vesting, one share of Common Stock. Pursuant to terms and conditions of 2018 Stock Incentive Plan. This award will vest in full on June 24, 2022. Not included in the reported award amount is a target amount of performance-based restricted stock units that will vest on June 24, 2022, but which are subject to the satisfaction of certain performance criteria other than solely the price of Casey's Common Stock; the final amount of shares earned, if any, will be reported upon vest and satisfaction of those performance measures. Pursuant to terms and conditions of 2018 Stock Incentive Plan. This award will vest in equal installments on June 15, 2021, June 15, 2022 and June 15, 2023. Not included in the reported award amount is a target amount of performance-based restricted stock units that will vest on June 15, 2023, but which are subject to the satisfaction of certain performance criteria other than solely the price of Casey's Common Stock; the final amount of shares earned, if any, will be reported upon vest and satisfaction of those performance measures. Pursuant to terms and conditions of Mr. Rebelez's "make-whole award" of June 24, 2019, granted in conjunction with his commencement of employment as Casey's President and CEO. These units vest over a three-year period in equal installments on each of the first three anniversaries of the grant date. Not included in the reported award amount is a target amount of performance-based restricted stock units that will vest on June 24, 2022, but which are subject to the satisfaction of certain performance criteria other than solely the price of Casey's Common Stock; the final amount of shares earned, if any, will be reported upon vest and satisfaction of those performance measures. Scott Faber, under Power of Attorney dated June 24, 2019 2021-01-13