0001376139-11-000013.txt : 20110516 0001376139-11-000013.hdr.sgml : 20110516 20110516172301 ACCESSION NUMBER: 0001376139-11-000013 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110513 FILED AS OF DATE: 20110516 DATE AS OF CHANGE: 20110516 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HAUGEN ROBERT W CENTRAL INDEX KEY: 0001403554 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33492 FILM NUMBER: 11848624 MAIL ADDRESS: STREET 1: C/O CVR ENERGY, INC. STREET 2: 2277 PLAZA DRIVE, SUITE 500 CITY: SUGAR LAND STATE: TX ZIP: 77479 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CVR ENERGY INC CENTRAL INDEX KEY: 0001376139 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE BUSINESS ADDRESS: STREET 1: 2277 PLAZA DRIVE STREET 2: SUITE 500 CITY: SUGAR LAND STATE: TX ZIP: 77479 BUSINESS PHONE: (281) 207-7711 MAIL ADDRESS: STREET 1: 2277 PLAZA DRIVE STREET 2: SUITE 500 CITY: SUGAR LAND STATE: TX ZIP: 77479 4 1 primary_doc.xml PRIMARY DOCUMENT X0303 4 2011-05-13 0 0001376139 CVR ENERGY INC CVI 0001403554 HAUGEN ROBERT W C/O CVR ENERGY, INC. 2277 PLAZA DRIVE, SUITE 500 SUGAR LAND TX 77479 0 1 0 0 EVP, Refining Operations Common Stock 2011-05-13 4 S 0 5000 19.5 D 33691 D /s/ Susan M. Ball, Attorney-in-fact 2011-05-16