SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Green Frederec

(Last) (First) (Middle)
7102 COMMERCE WAY

(Street)
BRENTWOOD TN 37027

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Delek US Holdings, Inc. [ DK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Executive Vice President
3. Date of Earliest Transaction (Month/Day/Year)
08/07/2012
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 08/07/2012 M(1) 14,889 A $9.17 254,889 D
Common Stock 08/07/2012 S(1) 14,889 D $22 240,000 D
Common Stock 08/07/2012 M(1) 715 A $9.17 240,715 D
Common Stock 08/07/2012 S(1) 715 D $22 240,000 D
Common Stock 08/07/2012 M(1) 3,307 A $9.17 243,307 D
Common Stock 08/07/2012 S(1) 3,307 D $22 240,000 D
Common Stock 08/07/2012 M(1) 1,089 A $9.17 241,089 D
Common Stock 08/07/2012 S(1) 1,089 D $22 240,000 D
Common Stock 08/08/2012 M(1) 15,970 A $9.17 255,970 D
Common Stock 08/08/2012 S(1) 15,970 D $24 240,000 D
Common Stock 08/08/2012 M(1) 1,088 A $9.17 241,088 D
Common Stock 08/08/2012 S(1) 1,088 D $24 240,000 D
Common Stock 08/08/2012 M(1) 504 A $9.17 240,504 D
Common Stock 08/08/2012 S(1) 504 D $24 240,000 D
Common Stock 08/08/2012 M(1) 813 A $9.17 240,813 D
Common Stock 08/08/2012 S(1) 813 D $24 240,000 D
Common Stock 08/08/2012 M(1) 1,625 A $14.25 241,625 D
Common Stock 08/08/2012 F(1) 1,140 D $24 240,485 D
Common Stock 08/08/2012 S(1) 485 D $24 240,000 D
Common Stock 08/09/2012 M(1) 3,250 A $6.98 243,250 D
Common Stock 08/09/2012 F(1) 1,502 D $26 241,748 D
Common Stock 08/09/2012 S(1) 1,748 D $26 240,000 D
Common Stock 08/09/2012 M(1) 14,141 A $9.17 254,141 D
Common Stock 08/09/2012 S(1) 14,141 D $26 240,000 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (Right to Buy) $9.17 08/07/2012(1) M 14,889 (2) 06/10/2019 Common Stock 14,889 $0 45,111 D
Employee Stock Option (Right to Buy) $9.17 08/07/2012(1) M 715 (3) 06/10/2017 Common Stock 715 $0 0 D
Employee Stock Option (Right to Buy) $9.17 08/07/2012(1) M 3,307 05/09/2010 05/09/2016 Common Stock 3,307 $0 0 D
Employee Stock Option (Right to Buy) $9.17 08/07/2012(1) M 1,089 (4) 06/10/2018 Common Stock 1,089 $0 1,088 D
Employee Stock Option (Right to Buy) $9.17 08/08/2012(1) M 15,970 (2) 06/10/2019 Common Stock 15,970 $0 29,141 D
Employee Stock Option (Right to Buy) $9.17 08/08/2012(1) M 1,088 (4) 06/10/2018 Common Stock 1,088 $0 0 D
Employee Stock Option (Right to Buy) $9.17 08/08/2012(1) M 504 06/10/2011 06/10/2017 Common Stock 504 $0 0 D
Employee Stock Option (Right to Buy) $9.17 08/08/2012(1) M 813 06/10/2012 06/10/2018 Common Stock 813 $0 0 D
Stock Appreciation Right $14.25 08/08/2012(1) M 1,625 (5) 06/10/2021 Common Stock 1,625 $0 4,875 D
Stock Appreciation Right $6.98 08/09/2012(1) M 3,250 (6) 06/10/2020 Common Stock 3,250 $0 3,250 D
Employee Stock Option (Right to Buy) $9.17 08/09/2012(1) M 14,141 (2) 06/10/2019 Common Stock 14,141 $0 15,000 D
Explanation of Responses:
1. This transaction was made pursuant to a Rule 10b5-1 plan that the reporting person entered into on May 10, 2012.
2. The option vests ratably on the first four anniversaries of June 10, 2009.
3. The option vested with respect to 1,430 shares of Common Stock on December 10, 2009 and with respect to 715 shares of Common Stock on June 10, 2010.
4. The option vested with respect to 1,089 shares of Common Stock on each of December 10, 2009 and June 10, 2010 and with respect to 1,088 shares of Common Stock on June 10, 2011.
5. The stock appreciation right vests ratably on the first four anniversaries of June 10, 2011.
6. The stock appreciation right vests ratably on the first four anniversaries of June 10, 2010.
Remarks:
/s/ Frederec Green 08/09/2012
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
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