U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
OMB APPROVAL
OMB Number 3235-0287
Expires: January 31, 2005
Estimated average burden
hours per response.......0.5
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or
Section 30(f) of the Investment Company Act of 1940
[_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Peter G. Peterson
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(Last) (First) (Middle)
345 Park Avenue, 31st Floor
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(Street)
New York, New York 10154
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Premcor Inc. Symbol: PCO
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3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Day/Year
January 29, 2003
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[_] Director [X] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[_] Form filed by More than One Reporting Person
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Table I--Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5. Amount
4. Securities Acquired of Securi- 6. Own-
(A) or Disposed ties Bene- ership
2A Deemed 3. Trans- of (D) (Instr. ficially Form:
Execution action 3, 4 and 5) Owned Follow- Direct 7. Nature of
2. Trans- Date, if Code ----------------------- ing Reported (D) or Indirect
1. Title of action any (Instr. 8) (A) Transaction(s) Indirect Beneficial
Security Date (Month/ (Month/ ---------- Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) Day/Year) Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock 1/29/03 P 1,300,000 A $19.20 29,117,104 I See Note 1
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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).
(Over)
SEC 1474 (3-99)
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FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. Num-
ber of 10. Own-
Deriv- ership
ative Form
5. Number 7. Title and Secur- of
2. Con- of Deri- Amount of ities Deriv- 11.
version tive 6. Date Underlying Bene- ative Nature
or 3A Securities Exercis- Securities ficially Secur- of
Exer- Deemed Acquired able and Instr. 3 Owned ity: In-
cise Execu- 4. Trans- (A) or Expiration and 4) 8. Price Follow- Direct direct
Price 3. Trans- tion action Disposed Date (Month ------------- of Deri- ing (D) or Bene-
1. Title of action Date Code of (D) Day/Year) Amount vative Reported In- ficial
of Deriva- Date Date if any (Instr. (Instr. 3, --------------- or Secur- Trans- direct Owner-
tive ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity actions (I) ship
Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Explanation of Responses:
(1) Blackstone Management Associates III L.L.C. ("BMA"), as General Partner
of Blackstone Capital Partners III Merchant Banking Fund L.P., Blackstone
Offshore Capital Partners III L.P. and Blackstone Family Investment
Partnership III L.P. is deemed to beneficially own such shares held by
such entities. The Reporting Person is a founding member of BMA and as
such may be deemed to share beneficial ownership for the shares owned by
Blackstone Capital Partners III Merchant Banking Fund L.P., Blackstone
Offshore Capital Partners III L.P. and Blackstone Family Investment
Partnership III L.P. Each of BMA and the Reporting Person disclaims
beneficial ownership of such shares.
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/s/ Peter G. Peterson
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Date: January 31, 2003
** 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 provided is insufficient, see Instruction 6 for procedure.
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