SEC Form 4
FORM 4 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
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Ellison Seth M.

(Last) (First) (Middle)
C/O LEVI STRAUSS & CO.
1155 BATTERY STREET

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LEVI STRAUSS & CO [ LEVI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
EVP & Chief Commercial Officer
3. Date of Earliest Transaction (Month/Day/Year)
11/08/2021
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock 11/08/2021 D 12,099 D $27 41,596 D
Class A Common Stock 11/09/2021 C(1) 27,783(2) A $0.00 69,379 D
Class A Common Stock 11/09/2021 S(1) 29,390 D $27.02 39,989 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Appreciation Rights $6.9 11/08/2021 M 19,961 (3) 02/01/2024 Class B Common Stock(4) 19,961 $0.00 35,254 D
Class B Common Stock (4) 11/08/2021 M 19,961 (4) (4) Class A Common Stock 19,961 $6.9 19,961 D
Class B Common Stock (4) 11/08/2021 D 12,948 (4) (4) Class A Common Stock 12,948 $27 7,013 D
Stock Appreciation Rights $9.6 11/08/2021 M 43,035 (5) 01/30/2025 Class B Common Stock(4) 43,035 $0.00 28,690 D
Class B Common Stock (4) 11/08/2021 M 43,035 (4) (4) Class A Common Stock 43,035 $9.6 50,048 D
Class B Common Stock (4) 11/08/2021 D 29,951 (4) (4) Class A Common Stock 29,951 $27 20,097 D
Stock Appreciation Rights $14.875 11/08/2021 M 36,340 (6) (4) Class B Common Stock(4) 36,340 $0.00 36,330 D
Class B Common Stock (4) 11/08/2021 M 36,340 (4) 01/29/2029 Class A Common Stock 36,340 $14.875 56,437 D
Class B Common Stock (4) 11/08/2021 D 28,654 (4) (4) Class A Common Stock 28,654 $27 27,783 D
Class B Common Stock (4) 11/09/2021 C(1) 27,783(2) (4) (4) Class A Common Stock 27,783 $0.00 0 D
Explanation of Responses:
1. Transaction pursuant to a previously established Rule 10b5-1 Plan.
2. Represents the conversion of Class B Common Stock into Class A Common Stock held of record by the Reporting Person.
3. The original grant was for 147,240 SARs, of which 36,810 SARs were exercised. 25% of the SARs vested on February 1, 2018, and 1/3 of the remaining SARs vest annually beginning on February 1, 2019.
4. 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.
5. 25% of the SARs vested on January 30, 2019, and 1/3 of the remaining SARs vest annually beginning on January 30, 2020.
6. 25% of the SARs vest on January 30, 2020, and 1/3 of the remaining SARs vest annually beginning on January 30, 2021.
Remarks:
/s/ David Jedrzejek, Attorney-in-Fact 11/10/2021
** Signature of Reporting Person Date
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.
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