0001209191-21-066781.txt : 20211124 0001209191-21-066781.hdr.sgml : 20211124 20211124160851 ACCESSION NUMBER: 0001209191-21-066781 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211122 FILED AS OF DATE: 20211124 DATE AS OF CHANGE: 20211124 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Bergh Charles V CENTRAL INDEX KEY: 0001436534 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-06631 FILM NUMBER: 211446511 MAIL ADDRESS: STREET 1: 105 CORPORATE CENTER BOULEVARD CITY: GREENSBORO STATE: NC ZIP: 27408 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 2021-11-22 0 0000094845 LEVI STRAUSS & CO LEVI 0001436534 Bergh Charles V C/O LEVI STRAUSS & CO. 1155 BATTERY STREET SAN FRANCISCO CA 94111 1 1 0 0 President and CEO Class A Common Stock 2021-10-29 5 G 0 E 659097 0.00 D 275641 D Class A Common Stock 2021-11-22 4 C 0 840468 0.00 A 1116109 D Class A Common Stock 1057235 I See Footnote Class A Common Stock 269000 I See Footnote Class A Common Stock 720000 I See Footnote Stock Appreciation Rights 6.10 2021-11-22 4 M 0 2263180 0.00 D 2023-02-09 Class B Common Stock 2263180 2263180 D Class B Common Stock 2021-11-22 4 M 0 2263180 6.10 A Class A Common Stock 2427630 2427630 D Class B Common Stock 2021-11-22 4 D 0 1422712 28.28 D Class A Common Stock 1422712 1004918 D Class B Common Stock 2021-11-22 4 C 0 840468 0.00 D Class A Common Stock 0 164450 D Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person. The shares are held in an irrevocable trust to which Mr. Bergh is Investment Direction Adviser and of which Mr. Bergh's family members are beneficiaries. The shares are held in another family trust formed in 2019 of which Mr. Bergh is trustee. The shares are held in a family trust formed in 2020 of which Mr. Bergh is trustee. Fully vested. 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. /s/ David Jedrzejek, Attorney-in-Fact 2021-11-24