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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
PREMCOR USA INC [ PCO ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 01/06/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) 01/07/2004 |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 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 |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 option (right to buy) | $26.14 | 01/06/2004 | A(1) | 2,500 | (2) | 01/06/2014 | Common Stock | 2,500 | $0 | 2,500 | I | by subsidiary(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. The option was granted pursuant to the Premcor Inc. Outside Director Compensation Program to Occidental C.O.B. Partners in lieu of its designee on the Premcor Board of Directors. |
2. The option vests in five equal annual installments beginning on January 6, 2005. |
3. Owned by Occidental C.O.B. Partners, an indirect wholly-owned subsidiary of Occidental Petroleum Corporation. |
/s/ J. R. HAVERT, Vice President and Treasurer | 01/14/2004 | |
** 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. | ||
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 Number. |
JOINT FILER INFORMATION
Name: | Occidental C.O.B. Partners | ||
Address: |
110 West 7th Street
P.O. Box 300 Tulsa, Oklahoma 74102 |
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Designated Filer: | Occidental Petroleum Corporation | ||
Issuer & Ticker Symbol: | Premcor Inc. (PCO) | ||
Date of Event Requiring Statement: | 01/06/2004 | ||
Signature: |
OCCIDENTAL C.O.B. PARTNERS
by OXY USA Inc., its managing partner |
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By: |
/s/ STEPHEN I. CHAZEN
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Stephen I. Chazen
Executive Vice President |
Page 3 of 7
JOINT FILER INFORMATION
Name: | Placid Oil Company | ||
Address: |
10889 Wilshire Boulevard
Los Angeles, California 90024 |
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Designated Filer: | Occidental Petroleum Corporation | ||
Issuer & Ticker Symbol: | Premcor Inc. (PCO) | ||
Date of Event Requiring Statement: | 01/06/2004 | ||
Signature: | PLACID OIL COMPANY | ||
By: |
/s/ STEPHEN I. CHAZEN
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Stephen I. Chazen
Executive Vice President |
Page 4 of 7
JOINT FILER INFORMATION
Name: | OXY USA Inc. | ||
Address: |
5 Greenway Plaza
Houston, Texas 77046 |
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Designated Filer: | Occidental Petroleum Corporation | ||
Issuer & Ticker Symbol: | Premcor Inc. (PCO) | ||
Date of Event Requiring Statement: | 01/06/2004 | ||
Signature: | OXY USA INC. | ||
By: |
/s/ STEPHEN I. CHAZEN
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Stephen I. Chazen
Executive Vice President |
Page 5 of 7
JOINT FILER INFORMATION
Name: | Occidental Oil and Gas Holding Corporation | ||
Address: |
10889 Wilshire Boulevard
Los Angeles, California 90024 |
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Designated Filer: | Occidental Petroleum Corporation | ||
Issuer & Ticker Symbol: | Premcor Inc. (PCO) | ||
Date of Event Requiring Statement: | 01/06/2004 | ||
Signature: | OCCIDENTAL OIL AND GAS HOLDING CORPORATION | ||
By: |
/s/ STEPHEN I. CHAZEN
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Stephen I. Chazen
Executive Vice President |
Page 6 of 7
JOINT FILER INFORMATION
Name: | Occidental Petroleum Investment Co. | ||
Address: |
10889 Wilshire Boulevard
Los Angeles, California 90024 |
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Designated Filer: | Occidental Petroleum Corporation | ||
Issuer & Ticker Symbol: | Premcor Inc. (PCO) | ||
Date of Event Requiring Statement: | 01/06/2004 | ||
Signature: | OCCIDENTAL PETROLEUM INVESTMENT CO. | ||
By: |
/s/ J.R. HAVERT
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J. R. Havert
Vice President and Treasurer |
Page 7 of 7