SEC FORM 4 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*
Wirth Michael K

(Last) (First) (Middle)
6001 BOLLINGER CANYON ROAD

(Street)
SAN RAMON CA 94583

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CHEVRON CORP [ CVX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman and CEO
3. Date of Earliest Transaction (Month/Day/Year)
11/04/2019
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
Common Stock 09/04/2019 G(1) V 440 D $0 17,784(2) I by Limited Partnership
Common Stock 09/04/2019 G(1) V 440 D $0 17,784(2) I by Limited Partnership
Common Stock 09/04/2019 G(1) V 440 D $0 17,784(2) I by Limited Partnership
Common Stock 09/04/2019 G(1) V 440 D $0 17,784(2) I by Limited Partnership
Common Stock 11/04/2019 S 3,961 D (3) 17,784(2) I by Limited Partnership
Common Stock 11/04/2019 S 3,961 D (3) 17,784(2) I by Limited Partnership
Common Stock 11/04/2019 S 3,961 D (3) 17,784(2) I by Limited Partnership
Common Stock 11/04/2019 S 3,961 D (3) 17,784(2) I by Limited Partnership
Common Stock 14,175 I by 401(k) plan
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
Explanation of Responses:
1. On September 4, 2019, the Wirth Revocable Trust made gifts of limited partnership interests, in each case representing a 2.475% interest in the limited partnership, to each of four separate trusts formed for the benefit of each of Mr. and Ms. Wirth's children (the "Children's Trusts").
2. The reporting person owns only a 1% general partnership interest in the limited partnership and disclaims beneficial ownership of these shares held by the limited partnership except to the extent of his pecuniary interest therein.
3. On November 4, 2019, the Wirth Revocable Trust sold limited partnership interests, in each case representing a 22.275% interest in the limited partnership, in private sales to each of the four Children's Trusts in exchange for a promissory note from each trust in a principal amount of $302,800, as determined by an independent appraisal of the fair market value of the limited partnership interests.
/s/ Christine L. Cavallo, Attorney-in-Fact for Michael K. Wirth 11/06/2019
** 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 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).
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