Haas Peter E. Jr. Form 3 LEVI STRAUSS & CO / Peter E. Jr. Haas ownership change

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 Peter E. Jr.

(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)
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)

X	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)
Common Stock(1)	29,117,700	I	See footnote(2)
Common Stock(1)	4,801,850	I	See footnote(3)
Common Stock(1)	400,000	I	See footnote(4)
Common Stock(1)	11,538,780(5)	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

Explanation of Responses:

1. Each share of Common Stock shall be reclassified into one share of Class B Common Stock immediately prior to the completion of the Issuer's initial public offering of Class A Common Stock.

2. The shares are held by the Peter E. Haas Jr. Family Fund, of which Mr. Haas is Vice President, for the benefit of charitable entities. Mr. Haas disclaims beneficial ownership of these shares.

3. The shares are held by trusts, of which Mr. Haas is trustee, for the benefit of others. Mr. Haas disclaims beneficial ownership of these shares.

4. Shares held by Mr. Haas' spouse. Mr. Haas disclaims beneficial ownership of these shares.

5. 49,430 of the shares are represented by restricted stock units (RSUs), 4,820 of which are issuable in respect of dividend equivalent rights on the RSUs. Each RSU represents a contingent right to receive one share of the Issuer's Common Stock upon settlement. The RSUs vest in a series of three (3) equal installments on the dates that are thirteen (13), twenty-four (24) and thirty-six (36) months following the date of grant.

Remarks:

	/s/ Cynthia Lee, Attorney-in-Fact	03/20/2019
	** 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).
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