Statement of Changes in Beneficial Ownership (4)
January 30 2018 - 4:24PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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
*
Pate R. Hewitt
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2. Issuer Name
and
Ticker or Trading Symbol
CHEVRON CORP
[
CVX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
VP and General Counsel
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(Last)
(First)
(Middle)
6001 BOLLINGER CANYON ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
1/28/2018
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(Street)
SAN RAMON, CA 94583
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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 Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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1/28/2018
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M
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11180
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A
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$0
(1)
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11180
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D
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Common Stock
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1/28/2018
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D
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11180
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D
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$131.19
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0
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D
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Common Stock
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3981
(2)
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I
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by 401(k) plan
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Common Stock
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18708
(3)
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I
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By Pate Family Trust
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Common Stock
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1680
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I
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by GRAT
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Common Stock
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1680
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I
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by Spouse GRAT
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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. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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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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Phantom Stock Units
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$0
(1)
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1/28/2018
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M
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11180
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(1)
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(1)
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Common Stock
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11180
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$0
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0
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D
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Explanation of Responses:
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(1)
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Each phantom stock unit is the economic equivalent of one share of Chevron Corporation common stock. The phantom stock units are payable in cash and vested on January 28, 2018.
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(2)
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Between October 17, 2017 and January 28, 2018, the reporting person acquired 111 shares of Chevron common stock under the Chevron Employee Savings Investment Plan, a 401(k) plan.
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(3)
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This number includes 1,320 shares previously reported as indirectly owned by GRAT and 1,320 shares previously reported as indirectly owned by Spouse GRAT, which are now indirectly owned by the Pate Family Trust.
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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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Pate R. Hewitt
6001 BOLLINGER CANYON ROAD
SAN RAMON, CA 94583
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VP and General Counsel
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Signatures
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/s/ Christine L. Cavallo, Attorney-in Fact for R. Hewitt Pate
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1/30/2018
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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 4(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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