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
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
Sey Jennifer A.

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

(Street)
SAN FRANCISCO CA 94111

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
11/30/2020
3. Issuer Name and Ticker or Trading Symbol
LEVI STRAUSS & CO [ LEVI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Brand President
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)
Class A Common Stock 81,919(1)(2)(3) D
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
Stock Appreciation Rights (4) 01/27/2030 Class A Common Stock 27,412 $20.25 D
Stock Appreciation Rights (5) 01/29/2029 Class B Common Stock 33,540 $14.875 D
Explanation of Responses:
1. The shares are represented by restricted stock units (RSUs).
2. Of these RSUs, (i) 52,080 RSUs vest on January 30, 2021, (ii) 7,560 RSUs represent the unvested portion of an RSU award that vests in four equal annual installments measured from January 30, 2019 and (iii) 13,020 RSUs represent the unvested portion of an RSU award that vests in three equal annual installments measured from January 30, 2019. These RSUs represent a contingent right to receive one share of the Issuer's Class B Common Stock upon settlement. 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.
3. Of these RSUs, 9,259 RSUs vest in four equal annual installments measured from January 27, 2020. These RSUs represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement.
4. The stock appreciation rights (SARs) vest in four equal annual installments measured from January 27, 2020.
5. The SARs vest in four equal annual installments measured from January 30, 2019.
Remarks:
/s/ Cynthia Lee, Attorney-in-Fact 12/09/2020
** 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.