SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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*
Haas Bradley J.

(Last) (First) (Middle)
C/O ARGONAUT SECURITIES COMPANY
1155 BATTERY STREET

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/20/2019
3. Issuer Name and Ticker or Trading Symbol
LEVI STRAUSS & CO [ LEVI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. 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 Beneficially Owned
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)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: 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
Class B Common stock (1) (1) Class A Common Stock 11,068,360 $0(1) D
Class B Common stock (1) (1) Class A Common Stock 807,680 $0(1) I Through a trust of which Mr. Haas is the trustee
Class B Common stock (1) (1) Class A Common Stock 3,283,190 $0(1) I Through a trust of which Mr. Haas is the trustee
Class B Common stock (1) (1) Class A Common Stock 239,810 $0(1) I Through a trust of which Mr. Haas is the trustee
Class B Common stock (1) (1) Class A Common Stock 2,781,450 $0(1) I Through a trust of which Mr. Haas is the trustee
Class B Common stock (1) (1) Class A Common Stock 58,250 $0(1) I By spouse(2)
Class B Common stock (1) (1) Class A Common Stock 120,930 $0(1) I See note(3)
Explanation of Responses:
1. Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of holder and has no expiration date.
2. Shares held by Mr. Haas' spouse. He disclaims beneficial ownership of these shares.
3. These shares are held in a custodial account of which Mr. Haas is the custodian for the benefit of others and for which he has sole voting and investment power. He disclaims beneficial ownership of these shares.
Ellyn Roberts as Attorney-in-fact for Bradley J. Haas 12/13/2019
** 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 5 (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.