Filing Details

Accession Number:
0001351541-17-000084
Form Type:
4/A
Zero Holdings:
No
Publication Time:
2017-03-20 19:20:11
Reporting Period:
2017-03-07
Filing Date:
2017-03-20
Accepted Time:
2017-03-20 19:20:11
Original Submission Date:
2017-03-07
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1351541 Delek Us Holdings Inc. DK () 4/A
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1292743 Norman Donald Holmes 7102 Commerce Way
Brentwood TN 37027
Executive Vice President No Yes No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2017-03-07 10,000 $10.65 40,748 No 4 M Direct
Common Stock Disposition 2017-03-07 4,262 $24.99 36,486 No 4 D Direct
Common Stock Disposition 2017-03-07 1,680 $24.99 34,806 No 4 F Direct
Common Stock Disposition 2017-03-07 4,058 $24.83 30,748 No 4 S Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 M Direct
No 4 D Direct
No 4 F Direct
No 4 S Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Stock Appreciation Right Disposition 2017-03-07 10,000 $0.00 10,000 $10.65
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
4,125 2021-12-10 No 4 M Direct
Footnotes
  1. This amendment is being filed to amend the Form 4 filed by the reporting person on March 7, 2017 (the "Original Form") to clarify that the reported 4,058 shares of Common Stock sold on March 7, 2017 were acquired upon exercise of a stock appreciation right on the same date and to correct the number of shares beneficially owned following such exercise in column 5 of Table I. The number of shares of Common Stock was also incorrectly reported in column 5 of Table I of the subsequent Form 4 filed by the reporting person on March 14, 2017.
  2. This amendment is being filed to also report the disposition of shares of Common Stock to Delek US Holdings, Inc. for payment of the exercise price in connection with the exercise of the stock appreciation right that was not previously reported in the Original Form 4.
  3. This amendment is being filed to also report the shares withheld to cover tax withholding obligations in connection with the exercise of the stock appreciation right that was not previously reported in the Original Form 4.
  4. The stock appreciation right vested with respect to 8,125 shares of Common Stock on each of December 10, 2012, December 10, 2013, December 10, 2014 and December 10, 2015.