0001209191-23-054854.txt : 20231109 0001209191-23-054854.hdr.sgml : 20231109 20231109165415 ACCESSION NUMBER: 0001209191-23-054854 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20231107 FILED AS OF DATE: 20231109 DATE AS OF CHANGE: 20231109 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Agarwal Indira CENTRAL INDEX KEY: 0001813753 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41325 FILM NUMBER: 231393456 MAIL ADDRESS: STREET 1: 2828 N. HARWOOD, SUITE 1300 CITY: DALLAS STATE: TX ZIP: 75201 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: HF Sinclair Corp CENTRAL INDEX KEY: 0001915657 STANDARD INDUSTRIAL CLASSIFICATION: PIPE LINES (NO NATURAL GAS) [4610] IRS NUMBER: 872092143 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2828 N. HARWOOD STREET 2: SUITE 1300 CITY: DALLAS STATE: TX ZIP: 75201 BUSINESS PHONE: 214-954-6696 MAIL ADDRESS: STREET 1: 2828 N. HARWOOD STREET 2: SUITE 1300 CITY: DALLAS STATE: TX ZIP: 75201 FORMER COMPANY: FORMER CONFORMED NAME: Hippo Parent Corp DATE OF NAME CHANGE: 20220307 4 1 doc4.xml FORM 4 SUBMISSION X0508 4 2023-11-07 0 0001915657 HF Sinclair Corp DINO 0001813753 Agarwal Indira 2828 N. HARWOOD ST. SUITE 1300 DALLAS TX 75201 0 1 0 0 VP, Controller and CAO 0 Common Stock 2023-11-07 4 A 0 3693 0.00 A 20267 D Restricted stock units granted under the HF Sinclair Corporation Amended and Restated 2020 Long Term Incentive Plan. The restricted stock units vest in three equal annual installments beginning December 1, 2024 (or on the first business day thereafter if such date falls on a weekend), provided that the reporting person remains in the employ of the Issuer from the grant date through each such vesting date. The vested restricted stock units will be paid within 30 days following the vesting date in the form of the Issuer's common stock equal to the number of vested restricted stock units. Exhibit List: Exhibit 24 - Power of Attorney Stacey L. Foland, Attorney-in-Fact 2023-11-09 EX-24 2 poa.txt POA DOCUMENT POWER OF ATTORNEY For Executing Form ID, Form 3, Form 4, Form 5, Form144 and Schedule 13D and Schedule 13G The undersigned hereby constitutes and appoints each of Vaishali S. Bhatia and Stacey L. Foland, signing singly, with full power of substitution, as the undersigned's true and lawful attorney-in-fact to: (1) Prepare and execute for and on behalf of the undersigned a Form ID (Application for Edgar Access) (including amendments thereto); or any other forms prescribed by the Securities and Exchange Commission, that may be necessary to obtain codes and passwords enabling the undersigned to make electronic filings with the Securities and Exchange Commission of the forms referenced in clause (2) below; (2) Prepare and execute for and on behalf of the undersigned any: (a) Form 3, Form 4, and Form 5 (including amendments thereto) in accordance with Section 16(a) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"); (b) Form 144 (including amendments thereto); and (c) Schedule 13D and Schedule 13G (including amendments thereto) in accordance with Sections 13(d) and 13(g) of the Exchange Act, but only to the extent each form or schedule relates to the undersigned's beneficial ownership of securities of HF Sinclair Corporation or any of its subsidiaries; (3) Do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to complete and execute any Form ID, Form 3, Form 4, Form 5, Form 144, Schedule 13D or Schedule 13G (including amendments thereto) and timely file the forms or schedules with the Securities and Exchange Commission and any stock exchange or quotation system, self-regulatory association or any other authority, and provide a copy as required by law or advisable to such persons as the attorney-in-fact deems appropriate; and (4) Take any other action in connection with the foregoing that, in the opinion of the attorney-in-fact, may be of benefit to, in the best interest of, or legally required of the undersigned, it being understood that the documents executed by the attorney-in-fact on behalf of the undersigned pursuant to this Power of Attorney shall be in such form and shall contain such terms and conditions as the attorney-in-fact may approve in the attorney-in-fact's discretion. The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform all and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this Power of Attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, and their substitutes, in serving in such capacity at the request of the undersigned, are not assuming, nor is HF Sinclair Corporation or any of its subsidiaries assuming, (i) any of the undersigned's responsibilities to comply with Section 16 or Sections 13(d) or 13(g) of the Exchange Act or (ii) any liability of the undersigned for failure to comply with such requirements. This Power of Attorney does not relieve the undersigned from the undersigned's obligations to comply with the requirements of the Exchange Act, including without limitation the reporting requirements under Section 16 or Sections 13(d) or 13(g) thereunder. The undersigned agrees that each such attorney-in-fact may rely entirely on information furnished orally or in writing by or at the direction of the undersigned to the attorney-in-fact. The undersigned also agrees to indemnify and hold harmless HF Sinclair Corporation and its subsidiaries and each such attorney-in-fact against any losses, claims, damages or liabilities (or actions in these respects) that arise out of or are based upon any untrue statements or omissions of necessary facts in the information provided by or at the direction of the undersigned, or upon the lack of timeliness in the delivery of information by or at the direction of the undersigned, to such attorney-in-fact for purposes of executing, acknowledging, delivering or filing a Form ID, Form 3, Form 4, Form 5, Form 144, Schedule 13D or Schedule 13G (including amendments thereto) and agrees to reimburse HF Sinclair Corporation and its subsidiaries and such attorney-in-fact on demand for any legal or other expenses reasonably incurred in connection with investigating or defending against any such loss, claim, damage, liability or action. This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Form ID, Form 3, Form 4, Form 5, Form 144, Schedule 13D and Schedule 13G (including amendments thereto) with respect to the undersigned's holdings of and transactions in securities issued by HF Sinclair Corporation or any of its subsidiaries, unless earlier revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact. This Power of Attorney does not revoke any other power of attorney that the undersigned has previously granted. IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of the date written below. /s/ Indira Agarwal Indira Agarwal November 8, 2023