0001209191-21-065529.txt : 20211118 0001209191-21-065529.hdr.sgml : 20211118 20211118170616 ACCESSION NUMBER: 0001209191-21-065529 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211117 FILED AS OF DATE: 20211118 DATE AS OF CHANGE: 20211118 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Friedman David A CENTRAL INDEX KEY: 0001768697 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-06631 FILM NUMBER: 211425250 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 4 1 doc4.xml FORM 4 SUBMISSION X0306 4 2021-11-17 0 0000094845 LEVI STRAUSS & CO LEVI 0001768697 Friedman David A C/O LEVI STRAUSS & CO. 1155 BATTERY STREET SAN FRANCISCO CA 94111 1 0 0 0 Class A Common Stock 2021-11-17 4 A 0 70 0.00 A 31651 D Class A Common Stock 45752 I See Footnote With respect to 25 dividend equivalent rights (DER), each of those DERs represents a contingent right to receive one share of the Issuer's Class B Common Stock upon settlement. 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. With respect to 55 of the DERs, the DERs shall vest in a series of three (3) equal installments on the dates that are thirteen (13), twenty-four (24) and thirty-six (36) months following the date of grant. With respect to 15 of the DERs for Class A Common Stock, the DERs shall vest as to 100% of the shares on the first anniversary of the date of grant. Settlement of DER in connection with restricted stock units (RSU). The rights accrued when and as dividends were paid on the Issuer's Class A Common Stock or Class B Common Stock, as appropriate, and became exercisable proportionately with the RSU to which they are related. Each DER is the economic equivalent of one share of the Issuer's Class A Common Stock or Class B Common Stock, as appropriate. The shares are held by the David A. Friedman 1993 Revocable Trust, of which the Reporting Person is trustee. /s/ David Jedrzejek, Attorney-in-Fact 2021-11-18