0001694426-18-000173.txt : 20180614 0001694426-18-000173.hdr.sgml : 20180614 20180614154748 ACCESSION NUMBER: 0001694426-18-000173 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180612 FILED AS OF DATE: 20180614 DATE AS OF CHANGE: 20180614 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Miller Anthony L. CENTRAL INDEX KEY: 0001650395 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38142 FILM NUMBER: 18899102 MAIL ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Delek US Holdings, Inc. CENTRAL INDEX KEY: 0001694426 STANDARD INDUSTRIAL CLASSIFICATION: PETROLEUM REFINING [2911] IRS NUMBER: 352581557 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 615-721-3715 MAIL ADDRESS: STREET 1: 7102 COMMERCE WAY CITY: BRENTWOOD STATE: TN ZIP: 37027 FORMER COMPANY: FORMER CONFORMED NAME: Delek Holdco, Inc. DATE OF NAME CHANGE: 20170111 4 1 wf-form4_152900565030076.xml FORM 4 X0306 4 2018-06-12 0 0001694426 Delek US Holdings, Inc. DK 0001650395 Miller Anthony L. 7102 COMMERCE WAY BRENTWOOD TN 37027 0 1 0 0 Executive Vice President Common Stock 2018-06-12 4 M 0 1625 30.10 A 12897 D Common Stock 2018-06-12 4 M 0 1625 36.53 A 14522 D Common Stock 2018-06-12 4 D 0 2005 54.03 D 12517 D Common Stock 2018-06-12 4 F 0 305 54.03 D 12212 D Common Stock 2018-06-12 4 S 0 2143 54.0436 D 10069 D Stock Appreciation Right 30.1 2018-06-12 4 M 0 1625 0 D 2017-06-10 2024-06-10 Common Stock 1625.0 0 D Stock Appreciation Right 36.53 2018-06-12 4 M 0 1625 0 D 2017-06-10 2025-06-10 Common Stock 1625.0 1625 D Reflects shares issued upon the exercise of stock appreciation rights granted to the Reporting Person on June 10, 2014, which vested ratably on June 10 of 2015, 2016, 2017 and 2018 and which were exercised by the Reporting Person on June 12, 2018. Reflects shares issued upon the exercise of stock appreciation rights granted to the Reporting Person on June 10, 2015, which vested ratably on June 10 of 2016, 2017 and 2018 and which were exercised by the Reporting Person on June 12, 2018. Disposition of shares of common stock to the Issuer for payment of the exercise price in connection with the exercise of the stock appreciation rights. Shares withheld to cover the tax withholding obligations in connection with the exercise of the stock appreciation rights. /s/ Anthony L. Miller 2018-06-13