Robert D. Haas - 28 Nov 2021 Form 5 Insider Report for LEVI STRAUSS & CO (LEVI)

Role
10%+ Owner
Signature
/s/ Parker Phillips, attorney-in-fact
Issuer symbol
LEVI
Transactions as of
28 Nov 2021
Net transactions value
$0
Form type
5
Filing time
10 Jan 2022, 15:12:06 UTC
Previous filing
01 Jun 2021
Next filing
09 Jan 2023
SEC
View on sec.gov

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction LEVI Class B Common Stock Other $0 -1,087,780 -100% $0.000000* 0 29 Sep 2021 Class A Common Stock $0.000000 By spouse F1, F2, F3
transaction LEVI Class B Common Stock Other $0 +1,087,780 +34% $0.000000 4,252,141 29 Sep 2021 Class A Common Stock $0.000000 By grantor retained annuity trusts of spouse F1, F3
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 On the Transaction Date, the reporting person's spouse distributed shares of Class B Common Stock to one or more grantor retained annuity trusts for the benefit of herself and the remainder beneficiaries. Mr. Haas disclaims beneficial ownership of these shares.
F2 Mr. Haas disclaims beneficial ownership of these shares.
F3 Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date.