Insider filing report for Changes in Beneficial Ownership
"Insiders might sell their shares for any number of reasons, but they buy them for only one: they think the price will rise"
- Peter Lynch
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- Peter Lynch
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FORM 3
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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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Remarks: Coffeyville Acquisition LLC and Coffeyville Acquisition II LLC each own shares of CVR Energy, Inc. (the "Company") commonstock, par value $0.01 per share ("Common Stock"). Mr. Clark owns common units equal to 0.097% of the total common units ofeach of Coffeyville Acquisition LLC and Coffeyville Acquisition II LLC. Mr. Clark also owns 976,152 phantom points pursuant to theCoffeyville Resources, LLC Phantom Unit Appreciation Plan (Plan I) and Coffeyville Resources, LLC Phantom Unit Appreciation Plan (PlanII). Phantom points constitute rights to a portion of the profits generated by Coffeyville Acquisition LLC and Coffeyville AcquisitionII LLC. The phantom unit appreciation plans are filed as exhibits 10.3 and 10.32 to the Company's Registration Statement onForm S-1, File No. 333-137588 (the "Registration Statement"). The limited liability company agreements of Coffeyville AcquisitionLLC and Coffeyville Acquisition II LLC are filed as exhibits 10.34 and 10.35, respectively, to the Registration Statement.Mr. Clark does not have the power to vote or dispose of the shares of Common Stock that correspond to his ownership of common unitsin Coffeyville Acquisition LLC and Coffeyville Acquisition II LLC and thus does not have beneficial ownership of such shares. In addition,Mr. Clark does not have any pecuniary interest in the shares of Common Stock held by Coffeyville Acquisition LLC and CoffeyvilleAcquisition II LLC (or phantom points) because he does not control either Coffeyville Acquisition LLC or Coffeyville AcquisitionII LLC and does not have or share investment control over either entity's securities.Exhibit List: Exhibit 24: Power of Attorney |
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). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.