Initial Statement of Beneficial Ownership (3)
20 August 2021 - 6:19AM
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
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3235-0104
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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
*
Neumann Dane J. |
2. Date of Event Requiring Statement (MM/DD/YYYY)
8/9/2021
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3. Issuer Name and Ticker or Trading Symbol
CVR ENERGY INC [CVI]
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(Last)
(First)
(Middle)
C/O CVR ENERGY, INC., 2277 PLAZA DRIVE, SUITE 500 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner
___X___ Officer (give title below) _____ Other (specify below)
Interim CFO, VP-Fin.&Treasurer / |
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(Street)
SUGAR LAND, TX 77479
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_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) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
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) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Incentive Units (1) | (1) | (2) | Common Stock | 855.0 | $0.0 (3) | D | |
| Incentive Units (4) | (4) | (2) | Common Stock | 1906.0 | $0.0 (3) | D | |
| Incentive Units (5) | (5) | (2) | Common Stock | 13506.0 | $0.0 (3) | D | |
| Explanation of Responses: |
| (1) | The Incentive Units were awarded to the reporting person by CVR Energy, Inc. on December 14, 2018. These Incentive Units vest ratably in three annual installments beginning in December of each year following the grant date, subject to the terms and conditions of the award agreement. |
| (2) | The Incentive Units expire immediately upon vest. |
| (3) | Each Incentive Unit reported herein represents the right to receive upon vesting, a cash payment equal to the average closing price of a share of CVR Energy, Inc. common stock for the 10 trading days preceding the vest date. |
| (4) | The Incentive Units were awarded to the reporting person by CVR Energy, Inc. on December 13, 2019. These Incentive Units vest ratably in three annual installments beginning in December of each year following the grant date, subject to the terms and conditions of the award agreement. |
| (5) | The Incentive Units were awarded to the reporting person by CVR Energy, Inc. on December 9, 2020. These Incentive Units vest ratably in three annual installments beginning in December of each year following the grant date, subject to the terms and conditions of the award agreement. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Neumann Dane J.
C/O CVR ENERGY, INC.
2277 PLAZA DRIVE, SUITE 500
SUGAR LAND, TX 77479 |
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| Interim CFO, VP-Fin.&Treasurer |
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Signatures
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| /s/ Dane J. Neumann | | 8/19/2021 |
| **Signature of Reporting Person | Date |
CVR Energy (NYSE:CVI)
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