Initial Statement of Beneficial Ownership (3)
June 21 2019 - 5:16PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
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INCHAUSTI DAVID A
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/16/2019
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3. Issuer Name
and
Ticker or Trading Symbol
CHEVRON CORP [CVX]
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(Last)
(First)
(Middle)
6001 BOLLINGER CANYON ROAD
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
_____ 10% Owner
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X
___ Officer (give title below)
_____ Other (specify below)
Vice Pres. and Comptroller /
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(Street)
SAN RAMON, CA 94583
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
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X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
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4470
(1)
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I
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by 401(k) plan
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Common Stock
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5750
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I
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by Spouse
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Non-Qualified Stock Option (Right to Buy)
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(2)
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1/26/2021
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Common Stock
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7200
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$94.64
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D
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Non-Qualified Stock Option (Right to Buy)
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(3)
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1/25/2022
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Common Stock
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5600
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$107.73
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D
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Non-Qualified Stock Option (Right to Buy)
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(4)
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1/30/2023
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Common Stock
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5600
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$116.45
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D
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Non-Qualified Stock Option (Right to Buy)
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(5)
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1/29/2024
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Common Stock
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4700
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$116.00
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D
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Non-Qualified Stock Option (Right to Buy)
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(6)
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1/28/2025
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Common Stock
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9500
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$103.71
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D
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Non-Qualified Stock Option (Right to Buy)
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(7)
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1/27/2026
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Common Stock
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22200
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$83.29
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D
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Non-Qualified Stock Option (Right to Buy)
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(8)
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1/25/2027
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Common Stock
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5800
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$117.24
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D
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Non-Qualified Stock Option (Right to Buy)
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(9)
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1/31/2028
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Common Stock
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5000
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$125.35
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D
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Non-Qualified Stock Option (Right to Buy)
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(10)
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1/30/2029
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Common Stock
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6000
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$113.01
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D
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Phantom Stock Units
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(11)
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(11)
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Common Stock
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417
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(11)
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I
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Excess Benefit Plan
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Restricted Stock Units
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(12)
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(12)
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Common Stock
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824
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(12)
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D
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Restricted Stock Units
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(13)
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(13)
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Common Stock
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772
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(13)
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D
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Restricted Stock Units
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(14)
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(14)
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Common Stock
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1238
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(14)
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D
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Restricted Stock Units
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(15)
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(15)
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Common Stock
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846
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(15)
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D
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Restricted Stock Units
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(16)
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(16)
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Common Stock
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1355
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(16)
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D
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Non-Qualified Stock Option (Right to Buy)
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(3)
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1/25/2022
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Common Stock
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3200
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$107.73
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I
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by Spouse
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Non-Qualified Stock Option (Right to Buy)
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(4)
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1/30/2023
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Common Stock
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3200
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$116.45
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I
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by Spouse
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Non-Qualified Stock Option (Right to Buy)
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(5)
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1/29/2024
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Common Stock
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2600
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$116.00
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I
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by Spouse
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Non-Qualified Stock Option (Right to Buy)
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(6)
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1/28/2025
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Common Stock
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5000
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$103.71
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I
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by Spouse
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Non-Qualified Stock Option (Right to Buy)
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(7)
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1/27/2026
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Common Stock
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7400
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$83.29
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I
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by Spouse
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Non-Qualified Stock Option (Right to Buy)
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(17)
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1/25/2027
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Common Stock
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1200
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$117.24
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I
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by Spouse
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Restricted Stock Units
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(12)
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(12)
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Common Stock
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159
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(12)
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I
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by Spouse
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Explanation of Responses:
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(1)
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This number represents the reporting person's shares of Chevron Corporation common stock under the Chevron Corporation Employee Savings and Investment Plan, a 401(k) plan.
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(2)
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Option granted 1/26/2011. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(3)
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Option granted 1/25/2012. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(4)
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Option granted 1/30/2013. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(5)
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Option granted 1/29/2014. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(6)
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Option granted 1/28/2015. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(7)
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Option granted 1/27/2016. One-third of the shares subject to the option vested on each of the first, second and third anniversaries of the date of grant.
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(8)
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Option granted 1/25/2017. One-third of the shares subject to the option vested on January 31, 2018, and one-third of the shares vested on January 31, 2019. The balance of the shares vests on January 31, 2020.
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(9)
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Option granted 1/31/2018. One-third of the shares subject to the option vested on January 31, 2019, and one-third of the shares subject to the option will vest on January 31, 2020 and January 31, 2021, respectively.
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(10)
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Option granted 1/30/2019. One-third of the shares subject to the option vest on January 31, 2020, January 31, 2021 and January 31, 2022, respectively.
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(11)
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Each phantom stock unit is the economic equivalent of one share of Chevron Corporation common stock. The phantom stock units, which are issued under the Chevron ESIP-RP, are payable in cash upon the reporting person's retirement or other termination of service.
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(12)
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Restricted stock units granted on 1/25/2017 under the Chevron Corporation Long-Term Incentive Plan. Each restricted stock unit is the economic equivalent of one share of Chevron Corporation common stock. Restricted stock units accrue dividend equivalents in the form of additional restricted stock units and are payable in cash upon vesting on January 31, 2022.
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(13)
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Restricted stock units granted on 1/31/2018 under the Chevron Corporation Long-Term Incentive Plan. Each restricted stock unit is the economic equivalent of one share of Chevron Corporation common stock. Restricted stock units accrue dividend equivalents in the form of additional restricted stock units and are payable in cash upon vesting on January 31, 2023.
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(14)
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Restricted stock units granted on 1/31/2018 under the Chevron Corporation Long-Term Incentive Plan. Each restricted stock unit is the economic equivalent of one share of Chevron Corporation common stock. Restricted stock units accrue dividend equivalents in the form of additional restricted stock units and are payable in cash upon vesting on January 31, 2021.
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(15)
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Restricted stock units granted on 1/30/2019 under the Chevron Corporation Long-Term Incentive Plan. Each restricted stock unit is the economic equivalent of one share of Chevron Corporation common stock. Restricted stock units accrue dividend equivalents in the form of additional restricted stock units and are payable in cash upon vesting on January 31, 2024.
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(16)
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Restricted stock units granted on 1/30/2019 under the Chevron Corporation Long-Term Incentive Plan. Each restricted stock unit is the economic equivalent of one share of Chevron Corporation common stock. Restricted stock units accrue dividend equivalents in the form of additional restricted stock units and are payable in cash upon vesting on January 31, 2022.
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(17)
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Option granted 1/25/2017. One-third of the shares subject to the option vested on January 31, 2018 and the remaining shares vested on September 6, 2018, the date of spouse's retirement.
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Remarks:
Exhibit List: Exhibit 24 - Power of Attorney
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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INCHAUSTI DAVID A
6001 BOLLINGER CANYON ROAD
SAN RAMON, CA 94583
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Vice Pres. and Comptroller
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Signatures
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/s/ Christine L. Cavallo, Attorney-in-Fact for David A. Inchausti
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6/21/2019
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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