0000899243-22-001767.txt : 20220112
0000899243-22-001767.hdr.sgml : 20220112
20220112171558
ACCESSION NUMBER: 0000899243-22-001767
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211128
FILED AS OF DATE: 20220112
DATE AS OF CHANGE: 20220112
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Haas Miriam L
CENTRAL INDEX KEY: 0001768680
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-06631
FILM NUMBER: 22527218
MAIL ADDRESS:
STREET 1: C/O LEVI STRAUSS & CO.
STREET 2: 1155 BATTERY STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: LEVI STRAUSS & CO
CENTRAL INDEX KEY: 0000094845
STANDARD INDUSTRIAL CLASSIFICATION: APPAREL & OTHER FINISHED PRODS OF FABRICS & SIMILAR MATERIAL [2300]
IRS NUMBER: 940905160
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1128
BUSINESS ADDRESS:
STREET 1: 1155 BATTERY ST
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
BUSINESS PHONE: 4155016000
MAIL ADDRESS:
STREET 1: 1155 BATTERY STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94111
5
1
doc5.xml
FORM 5 SUBMISSION
X0306
5
2021-11-28
0
0
0
0000094845
LEVI STRAUSS & CO
LEVI
0001768680
Haas Miriam L
C/O ARGONAUT SECURITIES COMPANY
1155 BATTERY STREET
SAN FRANCISCO
CA
94111
0
0
1
0
Class B Common Stock
2021-04-08
5
J
0
914825
0.00
D
Class A Common Stock
5085175
I
By grantor retained annuity trust
Class B Common Stock
2021-04-08
5
J
0
914825
0.00
A
Class A Common Stock
38774087
D
Class B Common Stock
2021-10-08
5
J
0
852205
0.00
D
Class A Common Stock
4232970
I
By grantor retained annuity trust
Class B Common Stock
2021-10-08
5
J
0
852205
0.00
A
Class A Common Stock
39526292
D
Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.
Shares reflect distributions from a grantor retained annuity trust for the benefit of the reporting person and the remainder beneficiaries.
/s/ Parker Phillips, Attorney-in-Fact
2022-01-12